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5?4
ANNALS
ATO \'(r'*d»
TRANSACTIONS
or THE
BRITISH HOMCEOPAI
SOCIETY,
AND OF THE
VOL IV.
(POBLISBBO BT ACTHORITT OF THE SOCIBTT.)
LONDON :
LEATH AND CO., 5. ST. PAUL'S CHUECH
And 9, VERB STREET, OXFORD STREI
1864.
PREFATORY NOTICE.
The completion of the Third Volume of " The Amials/'
demands but few prefatory remarks.
The Editing Committee have the satisfaction of con-
gratulating the Society on the steady success of the
publication, as evinced in the growing favour with which
its numbers are welcomed, both at home and abroad —
favour which proves the soundness of the principles
on which the work was commenced, and to which the
Editing Committee have strictly adhered.
The present volume, it is believed, will, in every res-
pect, bear favourable comparison with its predecessors.
This is due to the laudable zeal which has prompted the
production of so many valuable essays ; to the useful in-
formation, and free expression of opinion, contained in the
discussions ; and to the more extended form in which the
latter are reported. The Society is indebted to one of
its Corresponding Members for an interesting com-
munication, on a new medicine, which appears in the
latter pages of this volume.
vi Prefatory Notice,
Limited space has rendered it impossible for the-
Editing Committee to publish all the materials at their
disposal. In making their selection, they have been
guided, chiefly, by the practical character of the papers,
and by the amoimt of interest they excited, when read
before the Societ3\
In conclusion, the Editing Committee Avish to express
their gratification, at the increasing usefulness and pros-
perit}' of the London Homceopathic Hospital, whiclv
whilst it dispenses the blessings of Homoeopathy to large
munbers of the poor, continues also to afford to Medical
Inquu'ers, an opportunity of witnessing the practical
application of the principles propoimded by Hahnemann^
Frederic Foster Quix.
John Rutherfurd Russell^
Stephen Yeldham.
Hugh CA^rEROx.
CONTENTS.
Prefidorj Notice to the Third Volame of the Annals.
No. xni.
80C1ETT.
FAOE.
1. Is the Doctrine of lufinitessimals Consistent with Reason and Experience ?
By Dr. Samnel Cockbnm ...... I
2. Discussion (in which Dr. Hale, Dr. Metcalfe, Dr. Eiddj Dr. Drnry, Dr.
Wyld, Dr. Rnssell, and Dr. Chapman took part) . . • .29
3. Addressof the President, Dr. Qmn, at the Annnal Assembly of 1863 . 4»
4. Unpablished Letters of Hahnemann • . • . .61
HOSPITAL.
5. Concluding Lecture on Rhenmatism — On the Dose and the Alternation of
Medicines. By Dr. Russell ...... 72
6. Case of Ovariotomy ...••.. 91
No. xiy.
1. The Positive Services of the School of Hahnemann, Exemplified in the
Treatment of Acute Inflammatory Disease. By John Ozanne, M.D. . 97
2. Discussion (in which Mr. Ycldham,Dr. Hughes^ Dr. Russell, Dr. Chapman.
Dr. Chepmell, and Dr. Qnin took part) . . . . .113
3. On Some Afifections of the Knee-Joint. By Dr. Ransford . .128
4. Discussion (in which Dr. Drury, Dr. Russell, and Mr. Yeldham took part) . U I
6, Retrospect of 1862 . . . . . , .144
6. Some Unpublished Letters of Hahnemann . . . . IGo
HOSriTAL.
7. On some Morbid Affections of the Nervous System. Lecture I.— Epilepsy.
By Dr. Russell . . . . . . . .164
8. Cases treated with High Dilutions. By S. Yeldham, Esq., Surgeon to the
Hospital ......... 183
9. Cases by William V. Drury, M.D., M.R.LA., Physician Accoucheur to the
Hospital .... , • • 18S
vi Confnih.
No. XV.
8i»(IHT.
1. A Case of Kxtra Uterine Gestatiou. L>y Mr. I.«eadam . .193
2. DiscDSfioD (in which Mr. Cameron, Dr. Drary, and Dr. Qnin took part) SOS
3. On some Morbid Affections of the Ear. By Charles Cotmore, E«q.,
M.R.C.L.,&L.M.,Eng. ....... sio
4. Discussion (in which Dr. Drurj, Mr. Yeldhaui, and Mr. Cameron took
part) ......:.. 236
5. A Case of Hsmatnria and Albnminoria after Scarlatina Miliaria. Bj Dr.
Trinks ......... 228
6. Discussion (in which Mr. Teldham, Dr. Wjld (of London), Dr. Hughes,
Dr. Drury, Dr. Wilde Cof Winchester), and Mr. Cameron took part) 241
7. Cases of Opthalmia, with Opacity of the Cornea. By. Dr. Ozanne 246
8. Some Unpublished Letters of Hahnemann .... 254
9. On some Morbid Affections of the Nerroos System. Lecture IL — Epilepsy.
By Dr. Russell ,. ^ - . . . . . 258
10. Cases Treated with High Dilutions. By S. Yeldham, Esq., Snrgeon to the
Hospital ......... 283
No. XVI.
1 . Observations on the Physiolo^iuai aud Therapeutic Effects of Alcohol. By
Alfred C. Pope, M.RO.S. 286
2. Discussion (in which Mr. Cameron, Mr. F. H. Smith, Dr. Dmry, Dr. Ru8«ell,
Mr. Yeldham, and Mr. Pope took part) . . . . .310
3. Case of Gangrena Senilis. The last illness of Archbishop Whately. By
Dr. Scriven ........ 318
4. Discussion (in which Mr. Yeldham, Dr. Kidd, Dr. Morgan, Mr. Buck, Dr.
Russell, and Dr. Chapman took part) ..... 329
5. Observations on a Few Local Anaesthetics. By Dr. Eugene Cronin . 333
6. Discussion (in which Dr. Wyld, Mr. Cntmore, Dr. Drury, Dr. Russell, and
Mr. Cameron took part) ...... 339
HOSPITAL.
7. Lecture on Asthma, by Dr. Russell ..... 342
8. Cases Treated with High Dilutions. By S. Yeldham, Esq., Surgeon to the
Hospital . , , . . . . . . 362
AFPEl^DlX.
Fourteenth Annual Report of the London Uomoeopathtc Hospital . .371
Contents. vii
No. XVII.
•OdBTT. PAOB.
1. On the Alternations of Medicines. ByDr. Drjsdale . .871
2. Discnssion (in which the President (Dr. Qnin), Mr. Yeldham, Dr. Metcalf,
Mr. Reynolds, Dr. Chepmell, Dr. Dmry, Mr. J. Harmer Smith, Dr. Hale,
Dr. Russell, Dr. Drysdale, and Dr. Chapman took part) . . . 384
3. Notei on the Symptoms of Cerebral Disease. By Dr. Black . . 404
4. Diacaesion (in which Dr. Drury, Dr. Wyld, Dr. Hughes, Dr. Eidd, Mr. J,
Harmer.Smith, Dr. Russell, Dr. Black, and Dr. Chapman took part) • 424
5. On Diabetes Mellitus. By Dr. Neaiby . . . . .432
6. Discussion (in which Mr. Buck, Dr. Watson, Dr. Hamiltooi and Dr.
Neatby took part) ....... 455
7. Resolutions of the Society in regard to holding Profesaional Intercourse
with Unqualified Practitioners ...... 453
8. Cases Treated with High Dilutions. By S. Yeldham, Esq., Surgeon to the
Hospital ........ 460
No. XV lU.
fiOGIBTT.
O-, 1. OnAlbWnuria. By Dr. Gibbs Blake ..... 487
' 2. Discussion (in which Dr. Drury, Dr. Bayes, Mr. Leadam, Dr. Ransford,
Mr. Theobald, and Dr. Russell took part) .... 485
3. A Few Remarks on the Action of Hydrastis Canadensis in Cancer. By
Dr. Brtyes. ........ 489
4. Discussion (in which Dr. Drury, Dr. Hamilton, Dr. Metcalfe, Mr. Reynolds,
and Dr. Hall took part) ....... AOO
5. Remarks on Recent Cases of Poisoning by Calabar Beans. By. Mr. J.
Harmer Smith ........ 602
6. Observations on the Cactus Grandiflorus. ByDr. Rubini . . 508
7. Discussion (in which Dr. Russell and Dr. Yeldham took part) . . 512
HOSPITAL.
8. Lecture on Asthma. By Dr. Russell • . . . . .511
9. Cases Treated with Low Dilutions. Bj S. Yeldham, Esq., Surgeon to the
Hospital ......... 533
Index to the Third Volume . . . . . . .543
genitals af Ij^t Somlg*
IS THE DOCTRINE OF INFINITESIMALS CONSISTENT
WITH EEASON AND EXPEEIENCE ?
By Dk. Samuel Cockburn.
Mr. Chairman and Gentlemen, — ^Next to the law of Cure,
the subject of Dose occupies the most important position in
the practice of Homoeopathy. In regard to the law we are all
united, and herein lies our strength — therein lies our power.
In regard to the dose we are sadly disunited, and herein
lies our weakness — ^weakness within, deficiency of power
without.
I confess that I have found great difficulty in knowing how
to face this subject. At one time it has assumed the appear-
ance of an immense giant, whose vast proportions, armed cap-a-
pie, struck awe to one*s heart, and defied any attempt at attack.
At other times it has assumed the appearance of a phantom,
to fight with which would be like a man fighting with his own
shadow. Giant or phantom, let us face it.
In order to take a comprehensive, and at the same time, a
clear and definite view of the subject, I shall divide it into
eight short heads ; —
I. The Origin and Tendency of Infinitesimals.
II. Infinitesimals not Demanded by the Bequirements of
our Organization.
III. Why they Cure, and Why they Cause Aggravations.
IV. Tested and Found Wanting.
V. The Cause of Disunion, and an Obstacle to our Progress.
VI. The Doctrine of Infinitesimals is Unscientific :
1. Because Incomprehensible.
VOL m. 1
2 Is the Doctriiu of InfinitesimaU
2. Because Impracticable.
3. Because Uncertain.
VII. The Doctrine of Infinitesimals is opposed to and sub-
versive of Homoeopathy.
VIII. The Doctrine involves an Absurdity.
[As this paper is somewhat too long, I shall be obliged to
omit some portions of it]
I. — ^The Origin and Tendency of Infinitesimals.
Hahnemann is silent as to the causes which led him to the
introduction of infinitesimals. Why he did so, therefore, can
only be inferred from collateral evidence. What led him to
the discovery of Homoeopathy, and the evidences of its truth,
are given with openness and candour. What led him to the
introduction of infinitesimals, he kept a secret. The difference
between Homoeopathy and the old method of practice was not
so great as that subsisting between the infinitesimal doses
which he invented and those used in ordinary practice.
Homoeopathy was known before, and had been practised in a
limited form for ages ; but infinitesimal doses, such as those in-
vented by Hahnemann, and practised by some of his followers,
were never heard of before — ^never had any existence. It
is currently admitted that he was led to diminish his doses on
account of the aggravations which were sometimes observed
to follow their use. This reason has very generally been
received — and naturally enough — though no one has ever
alleged that these doses failed to effect cures. But to avoid
aggravations could not be the reason for the introduction of
infinitesimals. We can understand how a large dose should
give place to a small one, if the former appeared to act too
powerfully — how half-a-grain should be given in place of a
whole grain, or a quarter in place of a half, and so on ; but
we can see no relationship whatever between any degree of
aggravation ever recorded, and the infinitesimal dilution of
the drug frequently used oow. And then you wiU observe
Consistent with Reason and Experience f 3
that it was not in all the cases, not even in the majority of the
cases, that any unpleasant aggravations were produced by the
large doses : it was only in a few of them, in which monstrous
doses of powerful drugs were^given, that anything of the kind
was observed ; but the infinitesimal invention applied to every
kind of medicines, whether aggravations had ever been observed
by their use or no. And then Hahnemann, as well as many who
bear his name, afl&rm that aggravations happen more frequently
under the use of infinitesimals than by the use of large doses,
thus stultifying the original reason assigned for their introduc-
tion. I therefore cannot believe that this had anything to do
with the origin of these doses. There are only two alterna-
tives— either that Hahnemann was not led to the introduction
of infinitesimals fipom the fear of causing aggravations, but for
some other reason; or that the introduction has proved a
failure, — for aggravations occur more frequently under the use
of infinitesimals than by the use of large doses.
As is well known, Hahnemann, after discovering the Homoeo-
pathic law, established its truth by a record of facts drawn from
the experience of Allopathic practitioners, who, of course, had
effected their cures by the use of large doses. His faith in the
truth, therefore, and consequently in the superiority of Homoeo-
pathy over Allopathy, was based on results obtained by the
use of such doses. And when he commenced to follow the
law in his own practice, he not only had no intention of
giving doses different from those generally given by Allopaths,
but daily experience with such doses confirmed and estab-
lished his faith in their success. Small and infinitesimal
doses were then never dreamt of. For nine years he practised
Homoeopathy with the large doses of crude drugs used by Allo-
paths, and by these obtained cures which for rapidity and
beauty have never been surpassed. His success then was
the making of Homoeopathy. Every year's experience with these
doses gave fresh proofs that Homeopathy was true ; and every
year raised him in public estimation as a successful practi-
4 Is the Doctrine of Infinxtenmah
tioner. In 1799, his fame and reputation ran so high as to
attract the notice and arouse the jealousy of the medical
authorities in Wolfenbiittle, where he then resideil. And as
Halinemann's practice of dispensing his own medicines was a
direct violation of a national law, which nia<le it ini[)erative on
every medical practitioner to have his medicines prepared and
dispensed by an apothecary, an action was raised against him
by the apothecaries, whose privileges he had infringed upon.
The result of this was, that Hahnemann was debarred from
practising. All who have studied the nature of the struggle
between the great Medical Eeformer and the apothecaries, must
have observed that, to a very considerable extent, Hahnemann's
feelings got the better of his judgment. As an intelligent
man, Hahnemann must have felt that his case with the apothe-
caries was a hopeless one. They had the strong arm of the
law on their side ; he had none. How, at this period, he rea-
soned on the subject, we know not ; but the very next year
after this attack upon him by the apothecaries, we have the
first introduction of the infinitesimals. We have not the gradual
diminution in the size of the dose which we would naturally
have expected to find in the development of a new practical
fact, but the sudden and unlooked-for introduction of infinitesi-
mals. And he on more than one occasion afterwards pointed
to these infinitesimals as a triumph over the apothecaries, whose
services in future would not be required by medical practitioners,
and whose trade would therefore be ruined. Under cover of
these infinitesimals, he endeavoured to evade the law ; and some
years after that brought out his famous manifesto in defence of
his position, in which, by a species of special pleading which
no one can approve of, he endeavoured to show that the law
did not and could not apply to his peculiar kind of medical
practice.
Looking at these facts, I think we have veiy strong evi-
dence to suspect that the persecution referred to had something,
if not everything, to do in originating the infinitesimal doses.
Consistent with Reason and Experience f 5
II. — Infinitesimals not Dbmandkd by the Kbquieembnts
OF ouB Organism.
In every condition, in every circumstance of human exist-
ence, in savage equally as in civilized life, the body can appro-
priate for its support and growth only those substances which
in their constitution correspond to itself. Qualitative resem-
blance is an absolute necessity ; every departure from this frus-
trates the ends of nutrition and growth. But while qualitative
resemblance is so imperative, absolute quantitative relationship
is not so. Man is so constituted that, provided he gets what
is in its nature suitable, it is not necessary that he should
take it in such a quantity that it shall not by one grain, or by
one fraction of a grain, be above or below a certain given
standard. He lives, grows, and thrives on quantities and
proportions varying to a very considerable and, in some in-
stances to a very great extent. Were this not the case, and
if every fraction of a grain either in our bread, salt, or beef,
were to be followed by loss or suffering, what would our lives
be ? We cannot, could not by any means, know exactly to a
grain how much we need, and no more ; and if this is so, how much
less could we know to the hundredth, thousandth, or millionth
part of a grain the exact quantity we need ? God has so formed
our bodies, that we don't need to know this ; — ^practically, such
knowledge would be of no use. That man would be recognised
as a madman who should attempt to regulate his food by the
grain ; much more so, were he to estimate it by miUionths or
billionths.
The cure of disease can only be effected by a remedy having
a certain definite relationship to the disease. Whatever the
form, whatever the condition, — ^be it plant, mineral, or metal, —
this qualitative relationship is imperative. This qualitative rela-
tionship discovered and established by Hahnemann, we recognise
by the teim Homoepathy. In all ages of the world — ^in every con-
dition of human existence, civilized and savage — througkow^* viSi
6 Is the Doctrine of Infinitesimals
the reigns of diflTerent and opposing medical theories and systems,
cures have been eCTected in accordance with this qualitative rela-
tionship, and by quantities varying as much as we find to obtain
in the quantities of food used by different individuals. Our pre-
sent knowledge of the history of medicine has brought this con-
sjiicuously to light. Large doses have cured, and do still cure.
Small doses have cured, and do still cura A man may take too
much of the right kind of food, and an abnormal and uncom-
fortable condition of obesity ensue ; or he may take a great deal
too much, and die from gluttony ; or, again, he may take too
little, and the energy and strength of the system become im-
poverished ; or, he may take a great deal too little, and die fipom
starvation. But between death from gluttony and death from
starvation there is a wide range of degrees, and the right and
the i)roi)er are easily found by the great majority of mankind.
But that the right and the proper are comprised within limits
so marked, tliat the passing of which on the one side or the
other must entail suffering or loss, is not true. In the best of
health, our frxxl, in quantity, varies within certain conservative
limits, wliich have a considerable range every day, and that
variation has no effect upon us. The constitution of our bodies
is wondorfiiUy and beautifully adapted to this.
And just so in disease — a patient may take too much of the
riglit kind of medicine, and thereby produce disturbing drug
syniptoiriH; or he may take a great deal too much, and die in
coriH(jquorice ; or, again, he may take too little, and the disease,
unolKjckod, may extend its ravages in the system; or he may
tak(i far too little, and die from the disettse. But between death
from drug jioisoning and death from too little medicine there
is u wi(l(j lunge of quantities, within which range we are sure
in (jflciciiiig a cure, and within which we are quite as certain of
doing no liann. Infinitesimal quantities of the right kind of
food are bcjyond our capacities to appreciate, and unnecessary.
IrifinitcHinial qiuintitics of medicine are also beyond our capa-
cities to appreciate, and in the cure of disease are qidte un-
Consistent with Reason and Experience t «
necessary. The body, to live and grow, must have food ; dis-
ease, to be cured, must have medicine. To say that exactly so
many grains or so many drachms or ounces ought to be taken,
and no more, would be no more absurd than to say that the
billionth or trillionth of a grain was the only right quantity
to cure. The speculative theory which would defend the one
figment would equally apply in defence of the other phantom.
Let us be men guided by the real and the true. Science deals
with the known and knowable.
III. — ^Why they Cube, and Why they cause Aggravations.
It would be absurd to deny that aggravations, and aggrava-
tions of a very violent description, have taken place during the
use of infinitesimal doses. Authenticated facts of this kind,
from a variety of sources, place the subject beyond all doubt.
But, seeing that, comparatively speaking, large doses of the
same medicine used in similar diseases do not produce the
aggravations which are assigned to the infinitesimals, it is
evident that there must be some special reason to account for
the fact. It is not difficult to understand how the fourth
of a grain produces less effect than a whole grain, and how the
fiftieth part produces stUl less ; but that the ten thousandth
part of a grain, or a billionth part, should produce a greater
effect than the whole grain, cannot be understood without the
introduction of some special reason to account for the fact.
How do infinitesimals produce aggravations? Some years
ago I more than once met with patients who complained sadly
of having been much disturbed by the medicines they were
taking, the symptoms of their complaint having been much
aggravated, and who declared that they could not possibly con-
tinue to use it on account of its over-powerful action. This
annoyed and puzzled me for a long time, more especially as
the medicines then used were in infinitesimal doses from the
6th to the 12th potency, and sometimes higher. The fact
5 Is the Dortrinf of InfinittMmaU
:i..\: ctl.ers had often met with similar cases did not in any
irjTv-r Iv^son the difficulty. Tu sjiite of my own exj^erionce
az.: ::..;: of many others, the farts set'ined to me to involve a
:::.:rA.l:::i..a. and I resolved on tryin;^ s«jme exi>eriment« in
:r.'.-.r :■: J.v:emiine their meaning. To one patient who com-
^*.i::.v.l loudly of his mahuly having l»een aggravate<l, and
ii^ r:>>:\: strong fears that the honueoj^athic medicine was too
r«."3-rr:j.l, I gave powders of pure sugar of milk, and the aggra-
Ti::::ij weiv quite as strongly nuirked as Wfore. To another,
L ifni.CT. who complainetl of Ixiing much disturbed by the
n-i'i:.!::* I gave pure water, with a few droi>s of spirit of wine
ii. ::. i::I s::ll the aggravations continueil. In two or three
:•:! fr -.'i^s I loUoweii the s;une plan, and with the same results,
iLf £.c:-:T'.v;i:£oas Knng ijuite as much under the sugar of milk
ijil >\ :t:: .*: wine as under the globules. These facts forced
n-: :.' .vz.lnde that the aggravations were not pnxluced by
:!-■ ^'.V::>s a: all. but aiv>$e from a cause witliin the patient
l:r-:5rl; — hii a subjective origin. I ivmeml^r two of these
ri>-^ :u yA:t:.",:lAr. the patient* having left me altogether, de-
^jiTLT^ :h^y ivul.i &>: stand the tiwitment
Sur..^' li?;:- 1 hive me: with similar cases^ and have followed
±r -:i:,:>-> ry^\>K:e plan to that ivferrevl ta In place of giving
x-rr: --:i:~> rvce::iL«vi d^v^es. or puiv sugar of milk. I have
Ti^cr LZ ,-i::j.v, or in ;^>iuo C5is<>s gradually, come down to
x.i^zr:jLl :rSi,':-.-ciAl di\i^^ of the uuxli^ino which was found to
.-sii-s: -.1- i^riV3i:va. and in all suoh oas^>s 1 have found the
Acr^ -i~.-3: T,' >rtjfca^ ray:a:Y. 1 n<\\i no: ciil^rp? on this^
Yrn -J:*:>s*f rv\^ ^r.T!« of ex^^vriiuoutcv 1 a:u ^viiviuced that
iZ, *c^ '"i-.\irs A.vzrt*j:i: vixxTti;^: t!:e use of ir,t::u:e??™ils^ which
ijv r : ri^jLTsI 5fTwroc2::^;rri:* \>f iho o.:si<\-Uk\ r.::v>AvkTxi >y che
-r-=L:=-=u~ ij^ yzr.xriL-rt; ?>f jci iv,iprt>*3Uon v/,Av:e vn: :he iiiagi-
Z-Zi- > i:? i T^. «a\£ ^wiilN thN>*i* who tlrs: s.v:t:<' r:n%ier
:l=l-i-. -!.::_-■. T^scir^is::: iit'^'s? r>;>5 the faiutxx:^: id^ o: wbai
^:=rrj.'TiiL'i^\: ^srs^he^ >yn5«s». either a* iv^yxU their iubenrnt
Consistent vnth Reason and Eocperience t 9
properties or their strength. The name of the remedy and the
name of the potency make him in reality no wiser. In this
condition of ignorance it is natural that certain individuals
should expect to experience some imdefined kind of effect im-
mediately on taking a dose of those mysteriously powerful
drugs, of which probably they have heard some strange stories.
And further, it is not only natural, but it is certain, that the
impression thus formed on their imagination will manifest
itself in the direction of the morbid condition imder which the
patient is suffering, and that it will manifest itself either as a
special aggravation, or as a modification of the existing malady.
It is also quite certain that an alleviation of the complaint
may be produced in the same way, and it may even happen
that a curative result takes place after the previous aggrava-
tion. Sudden and strong mental impressions have often pro-
duced very serious diseases, and even death, and they have
also often produced miraculous cures. This is admitted by alL
That the aggravations in the cases referred to did actually
arise from an influence having a subjective origin cannot be
doubted, seeing that the aggravation ceased so soon as a suffi-
cient quantity of drug was taken to produce a real drug action.
As the excited imagination has the power of impressing itself
on the existing disease, and thereby producing aggravation ; so
the drug has the power of impressing its action on the sensitive
sphere, quite independent of the imagination, and thereby the
patient becomes conscious merely of a slight drug action — so
slight, indeed, as may merely suffice to counteract the effect of
the imagination and alleviate the malady.
Those who wish to cure disease by acting on the imagination
will find the 30 th or any higher potency a most suitable dose,
there being no fear of such doses interfering in any way with
either biological or magnetic influences. But those who believe
that drugs, when properly given, have the power of curing all
curable diseases, should see to it that in the treatment of dis-
ease they are really using drugs, and not mere names.
10 Is th€ Doctrine of InJiniiesimaU
IV. — Tested and Found Waitting.
Hahnemann recommended globule doses of the SOth attenu-
ation as being the most highly curative potency and dose of
the drug. True, ho substituted olfaction in place of the
globule in his latter years ; but as this part of Ilahnemannism is
not formally represented in our day, we need not consider it.
Many have gone far beyond their teacher in the potentizing pro-
cess, the 200th being frequently used by soma Some choose the
high potencies ; some choose the low ; and some, again, with an
accommodating profession of extreme liberality, choose all —
high and low, low and high, up and down, down and up, —
guided by what ? Yes, by what ? Will anyone tell me why
he chooses the SOth in place of the 29tli or 28th ; or why he
chooses the 60th in place of the Gist, or the 12th in place of
the 13 th, and so on ? What is his guide in choosing these ?
It cannot be experience, for most of the intermediate potencies
he has never tried, and in all likelihood never will try. Do
we call our friends over the way routinists? What is the
choice of the SOth potency but the highest embodiment of
routinism ?
There appears to me but one way of fairly and conclusively
testing the worth of these infinitesimals, and that is, to try
them in such cases as shall leave no doubt as to the effect of
the treatment upon the disease. Some complaints are very
capricious in their course and development, paroxysms of pain
coming on suddenly without any intimation, and often going
off as suddenly — old troublesome symptoms reappearing under
influences which we cannot always understand — abnormal con-
ditions, changes of mode of living, changes of weather,
atmospheric changes, &c., remaining away for years, or re-
turning in some new form. It is clear that it would not be
fair to test these doses in such complaints, because there might
be room to doubt whether the dose given really had anything
to do with the change that took place during its use. There
Consistent with Reason and Experience f 11
are some complaints, however, the natural course and history
of which we know so well that we can be certain as to the
effect of the treatment. I shall refer to one or two of these.
Thus, in hooping cough, Hahnemann recommends one
globule of the 30th potency of Drosera, which he says
will cure the malady in seven or eight days. like all of you,
I have had many opportunities of testing the truth of
Hahnemann's assertion on this point, and I have no hesitation
in saying that even in very simple uncomplicated cases, I have
not observed the slightest effect from the use of globules of
the 30th potency of Drosera, even after trying it for a longer
period than seven or eight days. I have also consulted many
authorities on the treatment of this complaint, and the whole
weight of testimony is dead against the eflftcacy of globules of
the 30 th potency. Drop doses of the 1st cent, of Drosera I
have often seen do good, though no one now trusts to this
medicine as the specific for every kind of hooping cough.
Hahnemann's reconmiendation of the 30th potency, and his
assertion about curing it in seven or eight days, can only be
looked upon as the offspring of his theory, and is very much
of a piece with the monstrously exaggerated statement he
makes about one drop of the 1 5th potency being sufficient to
endanger the life of a child. Hooping cough in a mUd form
disappears of itself, but globules of the 30th potency of
Drosera have no effect upon it.
In the treatment of itch, also, Hahnemann says that one
globule of the 30th potency of sulphur is sufficient to effect a
cure. Hahnemann's method has been tried times without
number, and found a failure. Now, itch, whether of recent or
longstanding, cannot be cured by globules of the 30th potency
of sulphur. The testimony of the profession is clear and ex-
plicit on this subject ; and it is highly questionable if Hahne-
mann himself ever did any good by it, or even tried it. We
have it on the testimony of Dr. Hartmann that Hahnemann
did not abide by the treatment he recommended to others. Iil
1 2 I A thf Dortrinf of InJinUesimaU
181G, t\v«Mily-six ywirs nftor the discoveiy of HomcDopathr,
nii«l sixt<*(>ii yoiirs at'trr tlie iiiv(*iition of infinitesimals. Dr.
Ilartiiiaiiirs bpitlirr Applied to Hahnoinann for the cure of
itch. IlaliiH'inann, of course, nrniiniiriidod sulphur, but not
one ^'Iiilmlo of the 3()th jMitiMuy — no, hut the 1st decimal, and
tliat lint in ;^h)hu1o doses, hut as nnuh as would cover the
])oiiil of a iKMiknifo; and not onro a fortnight, but three times
a (hiy. And, besides that, sulpliur ointment was to be rubbed
into the joints every ni^ht. This eminently rational treatment
was ]»erfe<'tly suc(;e8sful ; Hartniann's bnjther was cured, and
enjoyed perft^ct health afterwanls. This one fact upsets all
Hahnemann's theorisings alxjut the cure of itch by four globules
of the 30tli potency.
In s}^hilitic diseases, Hahnemann asserts that one globule
of the 30 th potency of mercury is sufticient for the cure. I
need scarcely say that this assertion has been disproved.
Evidence from every part of the world testifies that the 30th
potency of mercury has no effect on this disease; and the
practice, if followed out, would, to a certainty, be productive
of the most dire and destructive consequences.
Then in cholera, the universal voice of the profession is
against globules of the 30th potency. Even Hahnemann's
treatment of this disease with camphor, was heroic when com-
pared to that of all other Homceopathists now-a-days. Large
quantities of the saturated tincture were given internally ; the
same was given as an enema, and also rubbed largely all over
the body. Why in this disease should the potentizing theory
not hold good ? — ^why, if the curative power of the camphor
is more highly developed by the potentizing process, why not
use the drug in its most highly curative form in this highly
dangerous disease ? It is in rapid and dangerous diseases that
we require the highest resources of the medical art. Why,
if potentized drugs are best, do we not give the 30th potency
of camphor? In this case theory has failed to crush and
rule over the good sense of Hahnemann and that of his
Consistent with Reason and Experience i 13
followers ; and it is a blessing to the world that such has been
the case.
Is there any reason, in the nature of the case, why the 30th
potency should not be given ? Let us see.
First, in regard to the disease :
(a.) It cannot be because of the danger and fatality of the
disease, because there are many other dangerous and fatal dis-
eases in which the 30th potency is given. According to
Hahnemann's theory, the severity of the complaint does
not regulate the potency, were it the case that the danger
and urgency of the disease is to be the guide, as to the strength
of the dose; it would be an amusing application of the
Eule of Three to find out what degree of severity or danger
any particular disease would require to have to be treated by
the 30th potency, that of another being given which required
drop doses of the saturated tincture. Such a disease would
certainly be very highly attenuated.
(6.) It cannot be because the disease is one which runs a
very rapid course ; for we do not find this principle at all
acknowledged or acted upon by strict Hahnemannians. Diseases
running their course in a few days receiving the same 30 th
potency which is applied to others extending over months or
years.
Second, in regard to the drug :
(a.) It cannot be because camphor has a short period of
action in the body ; for this would account for the frequency
of repetition, but not for the strength.
(6.) It cannot be because the drug has a feeble or slight action
on the system; for camphor has a powerful action and in
strong doses produces alarming and fatal results ; an action
more powerful than carbo. calc. cam. silic, &c., which are
given in the 30th potency. Why then not be consistent, and
follow out the potentizing theory in this case? I look to
potentisers to give the answer.
I might here refer to gonorrhoea, but no one who knows
14 h the Doctrine, of InfiniUsimaU
aiivtliint; of the trimtmoiit of Ruch complaints imagine that
^luhiilis of tlio 3(»tli iM»tt'iicy have any effect at alL If then
^Inhiilrs of tlio 3()th potciu'V of the tnio carative remedy
art* fouinl to he iuo|M>r:itivc in those complaints mentioned, what
coiK-lii.sion are we to come to ? Hahnemann says the 30th
potcnry is the most hi^'lily cunitivc in all diseases, but what
he says in ref^^nl to the general use of the 30th potency has
no more evi<If'ncc to su])iKirt it than what ho says in regard
to its special eflicacy in hooping cough, itch, and syphilis.
But the testimony of facts jimves that the 30th potency has
no effect in these s])C('ial com])laints, and we are therefore
warranted in concluding that it lias no effect in general use —
no effect in any.
V. — ^The Cause of Disunion, and an Obstacle to our
PUOGRESS.
Homoeopathy, as a principle, can be demonstrated — ^proved to
be true ; and when fairly examined, it has commanded the assent
of every intelligent mind. The most that any of its bitterest
opponents have ever ventured on saying is, that while true in
principle, it is not of universal application. A large and prac-
tical knowledge of it, however, leads to the conclusion that it is
universally applicable in its own sphere. As a general truth,
harmonising with the highest exercise of reason, and also
with the results of experience, it is designed to be univer-
sally acknowledged. In this we look for unity — a unity
quite consistent with very considerable diversity in the special
individual apprehensions we may have of it. It is, perhaps,
impossible for any two minds to look at or apprehend
any one truth in every aspect of it exactly in the same
way. Being universal in application, we look upon it as being
designed to become universally practised. Absolute unity in
practice we know cannot be ; but there is a unity of practice as
well as a unity of principle quite consistent with very con-
siderable difference in detail We look forward to and strive
ConrnterU with Reaso'n and Experience f 15
for a universal unity in practice. Far be it ftom me to profess
such an amount of liberalism as would recognise one kind of
practice just as good as another, or that two opposite kinds of
practice can ever possibly be true. There can be only one
law of healing, and only one true mode of practica Of all
the systems of the past, no one has ever been based on a prin-
ciple of universal application; no one has ever harmonised
the relationship between drugs and disease ; no one has ever
had the character of perfection in principle, progressive
development in application, and catholicity in spirit. When
properly understood, Homoeopathy delivers from the bondage
and thraldom of all theories and dogmas, and gives the indi-
vidual practitioner a key and a guide to imlock every diffi-
culty— to cure disease with safety and certainty, if faith-
fully followed. But while it does this, it involves a higher
weight of individual responsibility than any other system ever
did. No one can ever be a true Homoeopathist who is guided
by the opinion of, or follows in the footsteps of, another.
The law must be his only guide — individual right and privi-
lege in choosing ; individual responsibility in faithfully acting ;
no casting blame on leaders or teachers. Along with this indi-
viduality of choice and universality of application, we look for
unity of practice, and we ought to hav^ it. In the choice —
in the selection of a drug for a special disease, we have
something like unity ; thanks to the definiteness and clearness
of the law for this. And this is a great matter ; but, in the
dose of the remedy, in its application, alas ! alas ! what have
we ? Unity ? E"o ; but the wildest confusion,' the most ex-
treme discord. In the application of the Homoeopathic law,
we have now a monstrosity of diversity such as never was
heard of, never conceived of — a diversity and a confusion
which baffles the mind to grasp. One practitioner gives a
drop of medicine, another gives a tenth part; one gives the
hundredth part, another gives the thousandth ; one gives a mil-
lionth, another gives the billionth; one gives a trilliontb.
16 Is the Doctrine of Injmitesimals
another the quadrillionth, and so on and so on without an
end, to a region requiring a new phraseology — a new lan-
guage, which corresponds to no conception of our mind,
and which we cannot understand. What is the value of such
contradictory experience as this ? What is the meaning of all
this discord — all this confusion ? There must be error somewhere.
No wonder our opponents have looked upon Homoeopathy as
quackery and tomfoolery. Can anyone approve of our present posi-
tion in this respect ? Can anyone defend it ? Can anyone desire
it to continue ? Surely not. And if not, what is to be done ?
The triumphant progress of Homcepathy has been to a great
extent arrested; and the precious blessings it is capable of dis-
pensing have been to a great extent shut up from a suffer-
ing world, and confined to a narrow and limited circle, by the
extravagant and irrational fancies of infinitesimal potentisers.
I have unbounded faith in the power of truth reaching the
hearts and understandings of men, if rightly advocated. The
opposition to Homoeopathy by the great majority of the pro-
fession has not been against Homoeopathy proper, but against
the errors and abuses that have been mixed up with it. Let
us learn a lesson from the past, and be wise. I am persuaded,
if Homoeopathy had been rationally practised and wisely advo-
cated, that instead of hundreds, we would now have been able
to count our numbers by thousands. We look for this, and we
ought to accomplish it.
Hahnemann discovered Homoeopathy, but Hahnemann in-
vented the doctrine of infinitesimals. There is a limit to all
human greatness ; there is always a something to mar human
glory. Hahnemann was not contented to be a discoverer, and
to be a humble servant and exponent of the truth which he
discovered, but, unfortunately, he set himseK up as a leader.
" Unless the physician imitates my method," and, " If phy-
sicians do not carefully "^practice what I teach, let them not
boast of being my followers." Such is his language. Homoeo-
pathy after this lost its catholicity. In place of being a gift
Consistent wUh Reason and Experience t 17
from (tocI Himself to a suiSeriiig world, suited for all men and
all times, it became marred like clay in the hand of the
potter, and became stamped with the characteristics of the
man ; and, as a consequence, we have actually a controversy
between the claims of Hahnemann and Homoeopathy. This
was his error; here he fell. And how many have fallen here !
As a leader, he invented the infinitesimals, and imposed them
upon his followers, making the adoption of these a test of
fellowship. Little did Hahnemann dream where this false step
was to lead to; but the moment the first step was taken,
HomcBopathy was launched on an ocean without a shore, and
such it has proved to be.
On seeing in the practice of others the extravagant lengths
to which the potentizing theory was being carried by some of
his followers, Hahnemann, apparently for the first time, saw the
danger to which it was leading, and exclaimed that " the thing
must stop somewhere." Stop somewhere ! how could it ? The
boundary line of science and experience had already been
crossed, and reason had left the helm ; how then could they
stop ? Error, like moral evil, never stands stilL Being misled
by a wild phantom, the very words of him whom they called
master were imheeded ; from one potency they went to another,
each new stage of extravagance but preparing them for a higher
and higher flight, nearer and nearer to the regions of fairyland.
Is this developing medicine as a science or as a caricature ?
Is this the way that Homoeopathy is to be raised in the esti-
mation of intelligent and scientific men ? Is it thus we ex-
pect to conquer the world ? Verily, no ; it is thus that dis-
cord and disunion have been sown in our ranks, our influence
in the world enfeebled, and the day of our final triumph post-
poned. Let us unite on a rational and scientific basis : thus
united. Homoeopathy shall move the world ; opposition shall
quail before its presence ; for it shall then manifest to the public
and the profession, not only the name, but the power, of the
true science and art of healing.
VOL. ni. 1
18 Is the Doctrine of InfinitemnaU
VI. — The Doctrine of Infinitesimals is Unscientific —
1st. Because incomprehensible.
The use of infinitesimals is destructive to all scientific pre-
cision in practice. One of the essential elements in every
science, and without which it cannot be called a science at all,
is, that in performing any operation or experiment, both the
quantity and the nature of the materials are really understood.
Infinitesimal potencies are not imderstood. All potencies
above the 1 2th are beyond the pale of calculation in so far as
mental conception is concerned. Whether we look upon the
potency as the representative of a disembodied force or of finely
divided atoms, the mind has no power of dealing with them ;
it is the process alone which is underatood, and it is the intel-
ligibility of the process that has misled both the practitioner
and the public. These potencies are spoken about, written
about, and used in such a familiar way as if we knew tho-
roughly what we were speaking about and using ; whereas m
reality no one knows anything about them, neither can he form
any conception regarding them. As a consequence, where men
once give themselves up to be led by the unknown and in-
conceivable in science, degrees of the unknown and inconceiv-
able are all alike. The tongue can jump with ease from the
6th to the 12th, from the 30th to the 60th, from the 100th
to the 200th, from the 500th to the 1000th potency; and it
is just as easy to speak of and understand the 200th or 2000th
as to speak of and understand the 30th or 12th. What do
these figures mean ? what do they represent ? I may be told
that they represent a particular stage in a process of prepara-
tion to which the drug has been subjected. Yes, these figures
represent processes, and nothing more. The profession and the
public imagined that they represented quantities of the drug,
but this is not so.
I do not for a mojient doubt but that every Homoeopathist
who administers infinitesimals holds that it is not tlie degree
Consistent with Reason and Experience / 19
or stage of process that is anything in the matter, but that it
is the drug, or force, in the particukr fonn or condition repre-
sented by the degree or process, that is everything. This par-
ticular condition or form of drug, or force, however, being be-
yond our capacities to conceive of or apprehend, cannot be the
subject of intelligent consideration or choice. This being the
case, one inconceivable or unknown quantity may just as well
be chosen as another ; but such a choice can have no claim to
logical or scientific precision.
In the practice of medicine, the mind perceives abnonnal
sensations, abnormal functions, and abnormal conditions of
structure ; it also perceives a more or less striking resemblance
between the pathogenetic symptoms of the drug and those of
the disease. In prescribing a remedy, the mind also perceives
the particular quantity and form in which it is to be used. In
choosing between different drugs, it is not mere signs or
symbols which are before the mind — ^it is not a choice between
A. and B., or between B. and C, but between certain definite
drugs ; and so in the same way in regard to the dose. The
choice ought to be made in regard to a certain definite quan-
tity of material, if material is believed in ; or of degree of force,
if the idea of force is entertained. But to do this there must
be a conception in the mind of the quantity or the degree, and
this quantity or degree is then represented by arithmetical
figures. It will never do to say that the mind conceives of
the 12th or the 30th potencies. The 30th potency simply
represents a stage in a process ; it is the symbol of a stage of
calclilation — it is not the thing ; it is neither the quantity of
matter nor the degree of force. The choice of any particular
process is easy enough, but the choice of any particular
degree ought to be determined by the previous choice of
what that degree represents. And as these degrees repre-
sent what surpasses the powers of the mind either to under-
stand or conceive of, it follows that we cannot make any intel-
ligent choice of them at aU ; processes are chosen, not doses.
i>\ 1$ the Doctrine of Infinitesimals
ijui ]\ hi unscientific, because impracticable.
JjL?..v.VAJ-vjiil jxitencies are picpared by the processes of
\r:.\\.*'k:.\..';:j, &iid succussion. The doctriuc of potentizing assumes,
Ic. \:j>a jj^^XUiT iij infinitely divisible; 2nd, that in the pro-
o*«>*h;3* './ trituration and succussion the particles of a definite
v:.t.:.;.v. of a drug undei^o a certain definite amount of sub-
c,»^l'-v:-: and 3rd, that the subdivision has no limit — ^it is
*- » J*:.
\'i'>.L7Ut dij$puting here the doctrine of the infinite divisi-
U,Jv.' of iriatt^r, a question of greater practical importance
zrlv:^>i at ihfi outset — namely, have we the means by which
yrti cajj ^Jivide matter infinitely? From the nature of the
<iueJ:tion, I know that no one will say we have. And if we
hnvh not, then to all intents and purposes it is not infinitely
diviisiblr^ Lut let us proceed to examine the processes. Firsl^
a£ to triturations.
To prrjjiare the first trituration, 1 gr. of a drug is triturated
with 99 grs. of sugar of milk for three hours; and as all the
I^articles both of the sugar of milk and drug are equally tritu-
rate^l, they must also be equally subdivided, — so that when the
operation is completed we have 99 times more particles of
sugar of milk than we have of drug. Absolute perfection in
this j)roce8S is impracticable; but assuming that perfection were
attained, wo would have throughout the mass 1 particle of
drug surrounded by 99 particles of sugar of milk. To prepare
the second, 1 gr. of the first is added to another 99 grs. of fresh
sugar of milk. Now, observe that the particles of the 1 gr. were
originally exactly of the same size as those of the sugar of
milk, and that it required three hours' rubbing to bring them
to their present condition. This mixture, then, of the 1 gr. of
the first trituration and 99 of sugar of milk is triturated for
another three hours. At the end of this period it is evident
that the last 99 grains of sugar of milk will be brought into
exactly the same state of subdivision as the 1 gr. was ; and the
question arises, does the 1 gr. which was previously triturated
Consistent with Reason and Experience t 21
undergo any farther subdivision ? If it does, then we must
have in the second trituration an irregular mixture of particles
of different sizes, which is highly improbabla Beason and prac-
tical experience in the matter would lead us to conclude that
aU the particles of the second trituration are, when the process is
carefully conducted, exactly of the same size ; so that the small
proportion of the drug in the 1 gr. of the first trituration under-
goes no further subdivision of its particles in No. 2, and the same
is the case in No. 3, the three hours' trituration merely serving
to bring up the fresh proportion of sugar of milk to the same
condition of subdivision as the 1 gr. which was added to it.
All the particles in the third trituration are of the same size.
In No. 1 we have 99 particles of sugar of milk for every 1 of
drug; in No. 2 we have 10,000 particles of sugar of milk for
every -1 of drug; in No. 3 we have 1,000,000 particles of
sugar of milk for every 1 particle of drug. The idea that the
drug is equally divided or spread through the whole sugar of
milk is utterly impossible, and yet the triturations are spoken
of as if every particle of sugar of nulk were impregnated with
or associated with a corresponding particle of drug — a notion
contrary to reason and fact.
Then, as regards the succussions, we have the very same«con-
dition. In the first tincture we have drug and spirit of wine.
The particles of the drug and the particles of the spirit of wine
have each a definite size ; and if the tincture is a real tincture,
and not merely a mixture or suspension, we have the particles
of the drug and the particles of the spirit of wine both of the
same size. It is quite impossible to conceive of the particles
of the drug in this instance being smaller than those of the
spirit of wine. Making this a starting point, then, we have in
No. 1, one drop of 6 added to 99 of spirit of wine, and well
shaken by 10 (some use 60) forcible jerks of the ann.
What is the result, and what have we ? We have, 1st, 1 drop
of 6, which, if you please, we shall call drug — one drop of
this drug, the particles of which are of a defimte size, and 99
22 Is the Doctrine of Injiniteeinials
drops of spirit of wine, the particles of which are also exactly
the same size. This being so, we have 99 particles of spirit of
wine to every 1 of drug ; by shaking this for any length of time
you like — 1 minute, 5 minutes, or 60 minutes — what occurs?
The drug particles and the spirit of wine particles both go
through the same process; are both subjected to the same
action ; the effect on the one must be the same as that on the
other — there can be no difference — so that at the end of the
process, however long continued, we have 99 times more par-
ticles of spirit of wine than of drug. If it can be supposed
that the particles of the spirit of wine may be subdivided by
the shaking, then it may also be supposed that the particles of
drug are proportionately subdivided ; but though spirit of wine
were shaken till doomsday we have no reason to believe that
its particles are ever altered in size, and certain it is that the
particles of the drug cannot be subdivided without those of
the spirit of wine undergoing a similar change, which is con-
trary to all reason.
In No. 2 we have 1 drop of No. 1 mixed with another 99 drops
of fresh spirit of wine, and again well shaken, and the change
which takes place is the very same as that which took place in
No. 1. The particles of the spirit of wine are of the very same
size as those of the 1 drop of No. 1, and no amount of shaking
can ever alter them. The drug particles are also of the same
size, so that practically at each new stage of dilution the par-
ticles of the original drug are rapidly getting fewer and fewer ;
and as they undergo no further subdivision, they must, in the
very nature of things, come to an end long, I believe, before
coming to the 30th potency.
From all this, I am bound to conclude that the infinite sub-
division of matter is impracticable, and that we have no reason
to believe it can be carried up to the 30th potency.
3. Unscientific, because imcertain.
Hahnemann recommended the attenuation of drugs to be
stopped at the 30th degree. Why? Why not carry the
Consistent vnth Reason and Experience t 23
process higher and higher, as has been done by some of his
followers, if it is true that the curative power becomes more
and more developed the higher we go ? Hahnemann recom-
mended that the process should be stopped at the 30th potency,
in order, he says, to secure uniformity in the strength used by
different practitioners all over the world. Uniformity ! What
could he mean ? Did he, or does anyone, imagine that two
different samples of the 30th potency, prepared by two different
individuals, with every amount of care and nicety, are uni-
form as regards the number of drug particles, or the amount of
drug power, they contain ? He must have had strange notions
of uniformity if he did. Uniformity in potencies is an im-
possibility, for the following reasons : —
1st. On account of the essential difference in the propor-
tion of drug force or active drug power contained in apparently
the same quantity of two different samples of the same drug.
2nd. Because of the difference in the precise number of
molecules in different samples apparently alike. A considerable
number of particles of a drug have no effect whatever in
turning the balance in any of the scales in ordinary use ; and
any difference at all in the number of molecules in the first
grain of the drug must make a great difference in the
potencies afterwards. I need not enlarge on these two heads.
Again, the first dilution of the drug is made by adding 1
drop of the drug juice to 99 drops of spirit of wine. Now,
it cannot be doubted that the one drop is intended to represent
a definite and uniform quantity — that it should contain a defi-
nite and uniform number of particles; but in pouring out
drops, I ask, is it at all possible to be sure that you have
always a drop of exactly the same size — a drop containing
exactly the same number of particles ? I have been engaged
in weighing grains and measuring drops for nearly 30 years,
and I am confident that no one can approach anything near to
certainty in this matter. Some one might be inclined to say that
a little difference is neither here nor there ; but a believer in
24 Is the Doctrine of InfinUmmaU
potencies cannot with any propriety say that, although practi-
cally, I liavo no doubt, it makes no diffeTcnee. The difference
in the size of difTerent drops often amounts to a great deal — ^I
believe frequently from the tenth to the fifth part of the whole.
Such a difTerence as this is e([ual to the difference of a con-
siderable number of potencies — a difference reckoned by
billions and trillions. From this I am forced to conclude
that not one of the potencies represents anything approaching
to a definite quantity, such as the number it bears would lead
us to expect ; that in most cases the same potency nominally
will vary to a veiy great extent ; that out of 30 samples, we
cannot make sure of having any two of them alika We may
have, in so far as quantity in the original drop is concerned,
one in reality representing the 20 th, another the 21st, another
the 22nd, and so on up to the 30tL This cannot be avoided.
Is this the way to secure uniformity ? Can such a practice
deserve the name of certainty or of precision. Then, in preparing
the triturations, besides the constant and unavoidable difference
in the absolute quantity of the first grain of the drug, there is a
very considerable quantity of the material which passes off during
the operation, and especially towards the termination. And
even allowing that the one grain of the first trituration, when
again triturated for three hours with a second 99 grs. of sugar
of milk, should undergo a still further subdivision of its
particles, it is clear that a very considerable proportion of this
one grain, from the extreme fineness of its particles, will at
once begin to escape from the mortar the moment the mixture
is agitated by the pestle, and that this escape will go on the
whole time of the three hours' trituration, and thereby cause a
very considerable loss. All who are practically acquainted
with the use of the pestle and mortar know this wclL No
doubt, as the trituration proceeds, the escape takes place from
the whole mass, including both sugar of Tm'lTr and drug ; but at
first, and during the earlier part of the process, the chief loss,
comparatively speaking, must be from the one grain of the first
Consistent with Reason and Experience t 25
trituration; and a loss of this kind, to any extent at all, mnst
tell to a vast extent on the succeeding potencies.
VII. — ^The Docteine op Infinitesimals Opposed to and Sub-
VEBSIVE OF HOM(EOPATHY.
Homoeopathy may be defined to be the curing of a disease
by a drug which has the power of producing in the healthy
body an artificial disease similar to the one under which
the patient suffers.
In this definition, three elements are introduced : —
1st. A knowledge of the symptoms of the drug disease.
2nd. A knowledge of the symptoms of the natural disease.
3rd. The administering of that very drug which produced
the artificial disease, the similarity of which to the natural
disease was the ground of its choice.
The theory and use of infinitesimals is opposed to this last
essential element. Let us see how this is so. In all fedmess,
this last element involves but one meaning — ^namely, that not
only must the drug used be the same in name as that which
produced the artificial drug disease, but it must also be
identical with it in regard to the nature of its mode of action :
the nature of the force it exerts must be the same. It may
differ in its form, in its quantity ; but it must not be in any
sense, or in any essential respect, different from the drug
proved. It must not only have the same original force which
the drug proved had, but it must possess no new power which
the original drug did not possess ; neither must it possess any
powers, newly developed in it by any process or processes to
which it may have been subjected, which were not in active
operation in the original drug, and by virtue of which it
produced its artificial drug disease. All this is abundantly
clear, and all this is distinctly contradicted by the theory of
infinitesimals.
The doctrine of potentization and dynamization implies that
drugs possess a deep-seated latent power which cannot be
:. '•• s-'^Lririot . but T* ^ ^2js
ii. : !.-. '.':.«! ' :. . * v ^".■. .- fi.:. .:'-] -.\: lai^t.-ri- tLr-.rle*
li:!\»- fp*.:! ;.:.-■..:- ■' i :'..•:• •-:-:lzi::j f-}^:-:::. Sr-n-r
l^li-Vi- :]i:.*. t:..- 1.:-:.: ;• ••'■•: :- r-i-r/.y > v->.ji*-lly the lonj-
«:«jijiiii?M-il j.jr.i-f.*^..^ •., v;., ?. !:.*,- ir:.'* fire su'^-jt-.ted : oti^rs
JMiiiviii" tii;il !;.•■:..• .- - :..-■ • '.- tr: .1 i..:-J *A ]».'W»'r Jf vek'jied or
)^roii;.'ljl into act i'.iij 'J;!i:.j ::.- :;:: .'-tliii' j r ":>-55 : and others
\A'.\\ii\i', i]iut tin.* nattJiL.! u;a:--.:-r of tL'j Jruj! is entu^elT
silt<.-j<"J in tli« cuujvi of j.ot'.-ijiiziii;:, Liid that the so-called
*Ji»j;? jjiatcml W;oiiJC'S i:jj]'j'.-L'ijat».-l Ly a liiaguetic pcwer
'•lij'rlly <l(.-jived 1j-<^iji the j^'.-i-soii of tlif: j^oteiitizer. All these
tii«o]j.:ft ani on a par; and whi'.h'.-vtr is held to he true, it
JiijiJy roiilj-adicts t]je cliiof ajid most essential element of
'iii«: j/i<iat majority of Iloma-opathists believe that the
|/i'i'<.-a i,f trituration and succussion operates simply by
Wjwdijij/ tiji' jiartides of the dru;;, so as to make their solution
"^ii'l^i- 1,: iuid t)ionMj;,di. TJjiH I l>eli*;v(i is all that is accomplished
*' 'ill tijiii. u r«'quinnl. lint a bidiciver in potencies may also
•"■ iii- iiJi.d Ui say that thci newly-(h;v«doped power is of the
-'ii»«. ijjitiji,..^ u,j,i dejMindrt upon th«j samd original i^ower which
*'""' ^ '*"■■ '*'■'*« «y*iJptoiim. Tni(!, tlic'ir origin may be the
"■ ■' ■>^'«ill«il^i 4;irrrtivi'. powi'i-H th(»y arc entirely dif-
I '• i.a hi.-lii i)„jt liny nciw power whatever is
»."•>• Jiij/j,jj^ i>*'"'«'Marrt, thnn my argument, that
"'''■"' ■'* *'' *'*»' «|'iiit of llomdiopathy, holds
'•*"*' V •'■>'.h..u Ihut //i,. ,M,wiT in the drug
^ . ' ' Z' '^'"'■"•"^ "*• •'»" iH'althy l)ody is ^A«
^'V »/'/^*^.*. whJMh IU-I.M rumtively on
// "' *' ''"'''"'■'■'♦ •'»•«« «)iMptoni8 in the
^" ' ^ nnrnn, *Mi M^ .„r,aivoly in
Consistent with Reason and Experience 1 27
the diseased body, then the Homoeopathic principle is sub-
verted.
If words have a meaning, there can be no doubt that the
new curative power said to be developed by the processes of
trituration and succussion, though naturally inherent in the
drug, was in a latent and inoperative condition, and could be
called into active operation only by the potentizing processes.
But the fact that the drug in its natural condition manifests
in the healthy body its characteristic disease-producing power,
proves that this its disease-producing power was not in a latent
condition, but operative ; and that, therefore, the latent power
developed by the potentizing process cannot be this disease-
producing power of the drug, but some other power. I am
therefore justified in concluding that the new curative power
developed by the potentizing process is different from the
disease-producing power of the drug, which is subversive of
Homoeopathy.
But if the potentizing processes do not develope any new
power, what becomes of the potentizing theory ? If the mul-
tifarious and minute processes recommended by Hahnemann,
with the sole and avowed purpose of developing a new power
formerly latent in the drug, fail in developing any such new
power, then the entire theory and processes of potentization
becomes a failure.
If the potentizing theory is given up, then the potentizing
processes ought to be abandoned ; for these processes were not
introduced by Hahnemann merely to subdivide the drug, but
in order to develope the new, often prodigious and over-
whelming power of the drug. Thorough subdivision of our
drugs is aU we require, and no mysterious potentizings. The
disease-producing power of the drug, which it manifests in its
ordinary subdivided condition, is the alone power which
cures disease. The-^evelopment of latent powers is a fabri-
cation.
Potentizers, to be consistent, ought to institute a new aecu»
28 Is the Doctrine of I^/initerinuU$
of provings with potentized drugs, and be guided in their
choice of a remedy by such provings ; but until this is done,
I hold that their present practice of being guided in the
selection of a remedy nominally by provings obtained by the use
of drugs whose inner or inmost drug power was latent and in-
operative, and then applying the drug with this its inmost
power prodigiously developed, is opposed to one of the cardinal
elements of Homoeopathy.
VIII. — ^The Doctrine of Infinitesimals involves ak
Absurdity.
The theory of potentizing and spiritualizing assumes that
the spiritual force of the drug is not only developed in the
processes of trituration and succussion, but that it is set firee
from its material embodiment. It is amusing to see how
fanciful statements of this kind have been accepted and
credited by men of intelligence, apparently without the slightest
question. Granting, for the sake of argument, that the drug
force is &eed £rom its material embodiment, in what form, I
would ask, does it exist in the sugar of milk ? Is it mixed
with the latter ; or how is it ? Have we any example of forces
mixing ; and what are they ? Is it not an established fact that
forces never mix, but that they always combine i Is it sup-
posed that the spiritual force formerly resident in the drug
combines with the sugar of milk, or that it combines with the
sugar of milk force ? If so, what reason have we to believe
that this new combination will manifest the same character as
the drug ? And supposing it has the same character — ^what is
gained? The spiritual force residing in the new compound
will require to leave that embodiment before it acts on the
organism, just in the same way as it would require to separate
from its natural embodiment — ^the drug.
In the liquid spiritualization, in what form have we the
drug force ? Is it simply mixed up with the spirit of wine ;
or how ? Have we any example of a force being shaken up
Consistent with Reason and Experience t 29
and mixed with water or spirit of wine ? Does the drug force
combine with the spirit of wine ; and, if so, what is the nature
of the new compound ? Is it drug— or what ? And if a new
compound, what becomes of the spiritualizing theory ?
We can act on matter, whether in the solid or liquid state,
and divide or mix it at pleasure ; but forces cannot be rubbed
in a mortar, or shaken in a bottla Forces can be evolved
only by decomposition; and decomposition can only take place
by the component parts of the substance entering into new
forms of arrangement — ^new combinations. Look at this sub-
ject of potentization in any way you like, it certainly does
appear ridiculous — nay, it is even absurd ; for just see. Is
it not an extraordinary idea, to talk about rubbing a force out
of matter ? Is it not equally extraordinary to talk about rubbing
a force into matter ? But, even supposing that the drug force
is rubbed out of the drug into the sugar of milk, must it not
follow that the same rubbing which rubbed the force out of
the drug material, will also rub the force out of the sugar of
milk ? If the force, then, is rubbed out of the drug, and also
nibbed out of the sugar of milk, and consequently is neither in
the one nor the other, wiU any potentizer teU me where it is ?
This lengthened and, I am afraid, in some respects tedious
paper is now finished. I fully expect that where such a variety
of material has been introduced, and that of a somewhat diffi-
cult character, deficiencies and errors must have crept in. I
shall now be glad to see these pointed out and corrected.
DISCUSSIONS.
Dr. Hale, while thanking Dr. Cockbum for his paper, which
gave the Society an opportunity of that full and free discussion
which the subject demanded, differed in toto from the conclu-
sions arrived at by Dr. Cockbum. Dr. Hale believed that Dr.
Cockbum's premises were false and faulty, and that therefore
his conclusions were also false and faulty. In the first place,
Dr. Cockbum had tried to prove the analogy between food and
dmgs — ^an analogy which Dr. Hale entirely denied. Dr. Hal^
30 /< th»' Dol/'iM of I Hji nit'. si mats
*..'.i'. :• :■ •! tii;it frx*<l was pn-ii-nti*! to the system in material
'j I :.'.•.•.. -■, }m/;iii.-.-, fptiii til.* v«ry iijitiire of its uses, it was
Ur: '.'i \ii*n t}j*r Tsv-ti'iii in orl«T tn Iwf assiiiiilatftl and deposited
Hi ;.'..i'» .'i;i! ^j»i;tiititii-i fur thf ;,T'»^»tli and dt-wloimient of the
\,-,'\ / N'lt -o, )iowiv»r, w»-p' drug's, which are taken into the
\. '- ::. ii'ft for ^Towth and (l«'V«-liiiniMnt, hut ft»r the purpose of
\,:'> .'..ir/ 'Jvnariii': ''han;j«-s in th»j or;;ani»Ltinn when disea5e<l
o' 'I. /i."! -p-'l. Tht'. ari^iiiiHiit fnr th»- n«*ct'?ssity of material doses,
?/;i ■• : jj/ori an anaIo;.'y which did nut «*xist, was therefore op-
{,', - i to -t'lt^uct: and jiliihi.'Oiihy. Dr. Ilsde, secondly, entirely
':■■ ' ;jN-'i from I)r. ^'ockhiirn's s*tut<*nn*nt, tliat the necessities of
'/::'.:r.i/;iti«iri n;'jiiind tliat drii^js shoiilil not l)e exhibited in in-
f*:..*i '.mill 'lovrH. Dr. Halt* inaintaimnl that all modem discovery
hv T;,': iiijcroHfoi*fi, 11h; niiniitii anatomy of the hmnan body, the
f;i// . of c#:II rh;v*rlopnir;nt and c^ill pathologj', jKjinted the other
v/ay, nu'\ rl^rarly \trhVi'A that if dnigs arc intended to reach the
/jjjijiiV: ilriictiire of any rlisoased oryan, they must be brought to
?:u':li a ;-.taU; of luinutc sulxlivision as will enable them to per-
iii*:itU: and iutt u])Ou tluj microscopically minute structures com-
j/o-.iii:' tlif! vttrir>ns or;;aiis. Dr. Hale consideretl the physical
tit'.':t::Mif*/A of our or;(anization one of the strongest arguments
in favour of infinite jsinial doses. Dr. Cockburn had introduced
an ai;MUMr;nt a^^ainst tlitj u«e of infinitesimals, from the uncer-
tainty u\ii\ unsatJHfactoriiHJHs of so-called medicinal aggravations;
\fUi ])r. Mal<% wliiKj aj^rf*(iing with Dr. Cockburn that there are
HjflirjiHiiH atUinding tlu? V(!rifying of aggi'avations, owing to the
important jiart wliich ofjrtiain ])hy.siological conditions play in the
I;li<'noni<rna of <liw-a.se; yet, while he blieved that aggravations
wtr*'. not ivi i'rc<iw,ui as some would wish us to believe, he had
iii'Vt'i-i^H'UHH fn'<jU(^ntly obsen-ed them occurring from infini-
t'rMJnjaldoM^jn, anrl had obs(Tved them occurring, moreover, during
lii;{ i'uvly <-xp( riinrjnts of Ilonimopathy, when the patients were
not at that iinir; awarcj that they were taking homoeopathic
rt-iwAu-.i thuH HO far eliminating both in the patients and in
hirn:'.'-.lf i\u\ mental cause of aggravations. Dr. Cockburn
donl»l,<'<l tho alIcg(Ml Ijwits of medicinal aggravation from the
jK'tiori <i\' ip<*dw;uanlia when inhaled in infiuitesimally minute
(liiruMion in the air; but Dr. Ilale would not occupy the time of
thn Society \ty (aichjavouring to prove that the accumulated
weight of evidence in i)roor of such an action of ipecacuanha
in i'AwUiwi i(IioHyneraci(jH was overwhelming, but instanced a case
the Hubjeel of whi(jh was a hard-headed allopathic sceptic, in
whom the minutc^st (piantity of white of egg (which contains
Hulffhur) in(hic(Hl an attack of acute eczema whenever he partook
of food (jontaining eggs in any shape. In Dr. Cockbum's paper
doubts vfiwv. (^xprejssod as to the action of infinitesimals in the
Consistent with Reason and Experience ? 31
treatment of syphilis ; "but Dr. Hale had succeeded in curing
primary Hunterian chancre with Merc. viv. 6th cent., and
secondary syphilitic ulceration of the throat with Lachesis 5th
and 6th centesimal. Dr. Cockbum's paper had an apparent
semblance of logical accuracy in treating the subject ; but Dr.
Hale considered his logic only apparent, and his deductions both
illogical and unsound — for instance, one of the arguments dwelt
upon at some length by Dr. Cockbum was, that the administra-
tion of infinitesimals was unscientific because their modus ope-
randi was incomprehensible. Dr. Hale said if this were true
there would be an end of the practice of medicine : if we were
to wait, before giving any medicine, until we knew exactly its
modus operandi, there would be an end to all progress, and
medicine would be an impossible art. As well might the astro-
nomer refuse to calculate the motions of the planets, or to accept
and use the laws of gravity until he had first discovered the
actual constitution of the sun. What allopath can tell exactly
the modus operandi of five grains of blue pill? Dr. Hale
could not follow Dr. Cockbum's argument as to how a grain of
any substance, with other grains of sugar of milk, conduct
themselves when saturated in Dr. Cockbum's mortar; but in
order to prove that matter was rendered visible to the senses up
to the fifth dilution, he instanced some experiments in spectrum
analysis made by him in the presence of the Secretary, at a /.JV
former meeting, in which Nitrate of Strontia and CarhoTUjUe of
Barytes were rendered perfectly sensible to sight in the 5th cent,
dilution. A theory of Homoeopathy had been propounded in the
paper just read, but Dr. Hale was not prepared to accept the
theory of Homoeopathy upon which Dr. Cockbum based his
argument. He was not prepared to receive even Hahnemann's
theory of Homoeopathy. When Hahnemann accumulated facts,
and from the induction by facts enunciated a laWy he was strong ;
when he theorised, he was weak. Dr. Hale did not think we
had yet a satisfactory theory of Homoeopathy. Our duty now
is to observe phenomena, and build up Homoeopathy by facts.
This led him to the very climax of Dr. Cockbum's argimient —
namely, that experience was against the use of infinitesimals.
If so, Dr. Hale contended, they are indeed a delusion and a snare,
and thousands of homoeopathic practitioners, and tens of thousands
of patients, have been for many years dreaming a fantastic dream.
If this be so, how comes it that most of the early trials, some
years ago, of the Homoeopathists of any standing were made
with infinitesimal doses, with attenuations from the 6th to the
30th, in globules ? Were our convictions of their worth then a
" delusion and a snare ?" For the first year of Dr. Hale's own
trials of Homoeopathy, he used little else but globules from. \,W
32 Is the Doctrim of InfinUesimaU
6th to the 30th ; but is it a dchision ? Is the Society prepared
to acco])t Dr. Cockbum's conclusions ? or does the accumulated
weight of evidence prove it othcm^'ise, and prove it beyond
doubt and from experience to be otherwise, than Dr. Cockbnm
would liavc us to believe ? Dr. Hale appealed to the experience
of every member present to substantiate his conviction as to the
power and value of infinitesimals. In conclusion, Dr. Hale said :
it is now-a-days sometimes stated that Homceopathy fails as it
used not to fail If this be so— and Dr. Hale was not prepared to
allow that statement to be true ; — he thought that if in any
cases it were true, the explanation is, that we had departed from
the teachings of Hahnemann ; that instead of building on the
sure foundation he laid, we allowed ourselves to become routinists,
or associated certain properties to certain drugs, and prescribed
them from some fanci^ relationship to certain organs, and forgot
or neglected to obey the law of homoeopathy. The failures must
be laid to the charge of the practitioner, and not to Homoeo-
pathy.
Dr. Metcalfe did not purpose entering upon the general sub-
ject so ably set forth by Dr. Cockbum. He wished only to
speak in reference to one or two matters that had been dwelt
upon. In the first place, he was surprised to find Dr. Cockbum
throwing doubt upon the fact of ipecacuanha producing asth-
matic sufferings. He knew an instance in point. The gentleman
with whom he was a pupil was thus aflfected. So sensitive was
he to the smallest particle of this drug that it was necessary to
inform him if the stopper of the bottle was removed. He never
could remain in the surgery during the use of it The mere
weighing out of a grain never escaped his notica He could
even tell if it had been used, should he within a short period pass
through the room ; and he well remembered on one occasion,
during the trituration of it, that he, sitting in an adjoining room,
rushed out calling, out " You are using ipecacuanha ! " Attacks of
sneezing, and a sensation of asthmatic constriction of the chest,
used to be produced by it. As to the question of the use of high
potencies of the medicines, he was of opinion that their efficacy
could not be doubted. Indeed, there were certain medicines
inert in their crude state, which in the 12th or higher potencies
I>roduced marked effects. He had seen the value of them in
tlio n;moval of small encysted tumours of the eyelids, and
Hubcutancous tumours on the scalp.
Dr. KiDD : I greatly admire the method Dr. Cockbum has
purHued in his ingenious and able paper. He started from the
tru(} point. He began with the history of Hahnemann. In the
first part of his career, Hahnemann appears truly grand and
noble. Then, following pure observation and true induction, he
Consistent with Reason and Experience t 33
discovered the grandest law of nature, Similia simUibus eurantur.
Let us recollect that for nine years he practised with minute
doses — not with infinitesimal During those nine years, in fact,
he founded the Homoeopathic system. All his teaching afterwards
was fanciful, and open to uncertainty and doubt, like the suc-
cessive theories of physicians through thirty centuries. Hahne-
mann's nature was not able to resist retaliation. He was fiercely
attacked, and he imwisely retaliated. When retaliation comes
into play, truth goes out. This was Hahnemann's error. Out of
contradiction and angry retaliation, he plunged into the doctrine
of infinitesimals, founded on imagination, not on induction. This
practice of giving medicines in quantities, so unnecessarily in-
finitesimal, is the bugbear that deters the majority of medical
men from joining our ranks. For my part. Upwards of ten years
ago I separated the truth of the homoeopathic law from the un-
certain hypothesis of infinitesimal doses, and my success in the
cure of disease increased tenfold as I followed the natural law of
cure, Similia similihis eurantur, imtrammelled by the fanciful
theories of dynamization. As far as Hahnemann followed truth
I follow Hahnemann, but no farther. I applied the same rule to
him as to Hippocrates and Harvey. I would follow all that is
true in the teaching of these great men, but I would not foUow
their blunders, nor feel bound to reverence their mistakes. It is
not for us who have cast down the ancient idols of medical wor-
ship. Authority and Theory — ^who have renounced allegiance to
fanciful hypotheses, to set up this poor modem idol of Dynami-
zation, and to fall down and worship Globulism. Along with
much truth, Hahnemann evolved much error. The theory of in-
finitesimal doses is a mere fanciful hypothesis, open to numerous ob-
jections. That error, I for my part have disowned, and do disclaim.
The truth of the law, Similia similUms eurantur, I firmly believe
in, as based on induction from the truest observation of facts and
value as the most faithful guide in the treatment of disease.
But I refuse to follow Hahnemann into the region of fanciful
hypothesis. I am a Homoeopathist in principle — not a Hahne-
mannist, nor a Globulist. Science tells us that there are limits
to the division of the metallic medicines. Dr. Hale says he de-
tected the presence of mineral medicine by the spectrum analysis
at the 5th dilution. If the spectrum cannot detect its presence
beyond the 5th dilution, why attempt to fancy the presence of
medicine when even the spectrum cannot detect it ? Surely the
state of division that the spectrum alone can detect is fine
enough for all practical purposes, and it is but fair to ask Dr.
Hale, why do you not rest satisfied with the utmost limits that
the spectrum analysis can detect ? Why give the 6th or 12th
dilution, when we know that there is an exquisitely diviH
VOL. m, ^
?, i Is iht Doctrine of Infinitesimals
?if. ::.''•* :..:.u. in tlir: 5th, and there xnay be nothing in the 12th
fi., .v^ri ' IM iifl follow truth for its own sake and conmioii
»> r.-'v . ;:r. I uf»i F^e UA into aliHunliticB out of deferenoe to Hahne-
rr.;irt.'.V; inuf/wH, I api^^l frr>m Hahnemann fanciful, theoretical,
st.r».\ '.: /t/.h'ft.y, to Hahnemann vigoroiLS and practical, in his
l»T,r:.f', 'A'\(*x(i v«;xatioiiH o{i|K)sition caused hiiu to retaliate.
\y:. \)V.v\ci ff:lt that our thanks were certainly due to Dr.
(^x.K',.:u for t.hi; 2i:al he Iiad shown in coming such a long
r:,..Sir.r/: If, uMv\ hi.H jififx^r Init having said that much, he regretted
V,h\ r.': *j»\\\t\ KLy notliing further in tlic way of praise, as he
'!;f^%'<'i fr^o alinoHt f;v<;ry word he luul heard. He had unfor-
iuu'A.U'\-f \^'j.i\ cjiiWt'A fiway curly in the evening, and so missed
tr>/; Un.t fi^irt ; but from wliat lie heaixl, it appeared to him that
u»f'. f/i,v:f 'a;ih all f4iii,*i;ulation, which was entirely outweighed by
f,rif; ■■'.itiuM'' 'Arf:ilw:.'4taljIi.H)icMl fuct, of wliicli there were numbers to
r^'i•i^/: hr. ^Vy^khimi. The first jxjint to which he would allude
wa>(, th^; iiovf:l viows stirted by the author on the divisibility of
ifthr/s. Uf, thought it was conceded that there was no limit
on t.hiy. \i(:nf\ ; li/iw^jvftr, if Dr. Cockbum would produce the atom
alr//Jif. v/},jf;h thfjy rlifff-rerl, he (Dr. Drury) would be very happy
t// ' >ifiiit iha tWWiroAiai" for him. The author was puzzled to
nnfUir-'.Unfl th^; |K;ft8ibility of bodies becoming incorporated by
any pn /Hi^:al a/;tion ; yet such tilings did occur. In the arts —
rKtfUir i/,wf'.rf\il j/ressure — metals could be very intimately
\Af-jAf'/\ by cli^jmical a/^tion ; new compounds were formed ; and
(;\oO.(.f.,ly j/rMliic^j/l vr;ry wonderful changes, which were every
fUiy c-Ac.Uu^^ our fuHtonlHliriient That trituration did develope
ut.'w [/'/W'-.fH in dni^.H, Wumh was not a shadow of doubt; even on
a th\i<f\i -/;ai<j Uii.H powfjrwjis demonstrated. Savory & Moore, the
tUfjm-'XH, of h}w\-HiT(i(ii, were celebrated for their seidlitz pow-
(if-SH. Now, thougli they used the same ingi'edients as other
tb^;rrji.Ht?j, yet their morle of operating produced a much better
artjcifj. Tbey mixf^l their ingredients in quantity in a large
w^KyJrji }h>x, UHing a shovel for trjssing the salts about till they
wrjre sufficiently mixfjd. Many other illustrations could be easily
HfUlucM, without res'irtj'ng Uj the known facts elicited by our
metb^><ls. As Dr. Cockbuni had lately fallen foul of Mr. Wilson,
he (Dr. Drury) would mention a case that made a very great im-
pression upon him when he was new to Homoeopathy, which
proved more to his mind than any amount of imsupported argu-
ment. A little child, about two years old, was suffering from
congestion of the lungs and other mischief. Being only a begin-
ner at that time. Dr. Drury, in treating this case, had obtained
the help of another homoeopath. For some days the child
continued to get worse, and a fatal result threatened. Circum-
stances occurred that compelled the gentleman in attendance to
Consistent vnih Reason and Experience t 35
be absent, and Mr. Wilson's advice was sought On seeing the
child at seven in the evening, he at once said that it was a
beautiful Chamomilla case, and would do well ; the respiration
was then eighty in a minute, with other well-marked symptoms.
Chamomilla 30 was given. On seeing the child at ten the same
evening, the respiration had fallen to fifty ; and from that time
the disease steadily yielded. This case showed the importance
of making a proper selection, and also that the 30th dilution
would act as effectually as any other in acute diseasa That the
Homoeopathic medicines would produce aggravations, was well
established. He had on different occasions seen the 30th dilution
of mercury affect the mouth. Probably, in these cases, the mer-
cury remaining in the system from the former Allopathic abuse
of the drug was called into play by the Homoeopathic dose, and
so produced the peculiar action of the drug. That syphilis and
gonorrhoea might be successfully treated with the 30th dilution,
there was no doubt. Some years ago, he (Dr. Drury) was attend-
ing a case of anthrax, of enormous size. There was at the same
time a venereal sore, to which his attention was called. Nitric
acid appearing to him to be suitable at the moment for both
complaints, he gave it in the 30th dilution, and the sore healed
as quickly as it was possible. He recollected very well attending
the brother of an editor of an influential journal, sufferii\g from
gonorrhoea and swelled testicla The brother of the patient said,
" Well, this is a fair case to try Homoeopathy in, for imagination
will not cure gonorrhoea and swelled testicle." There was no
difficulty in treating this case successfully with the 30th dilution.
Dr. Kidd claimed credit to himseK for picking out the good of
Hahnemann's system, and rejecting his blunders. It had yet to
be proved that what Dr. Kidd called blunders, were so ; on the
contrary. Dr. Eidd appeared to have missed some of the great
truths established by Hahnemann, and himself deserved the pity
he was so ready to bestow on the foiinder of Homoeopathy, — as
by setting up his own opinion in opposition to Hahnemann, he
committed a fatal error, and lost some of the chief good of Homoeo-
pathy. He had asked why Dr. Hale, having demonstrated the
existence of the medicine in the 5th dilution by means of the
spectrum, had not stopped there. The answer was very simple :
before ever the spectrum was heard of, Dr. Hale had become
convinced of the satisfactory action of the higher dilutions, and,
like a sensible man, had continued to use them. In conclusion,
he (Dr. Drury) must express his regret if anything had fallen
from him calculated to wound those from whom he differed ;
but when great truths were attacked, it was necessary they
should be defended.
Dr. Wyld observed that the paper just read had rfoa\3L\»\\. V)aa
30 /.< (he Ditctrine of InfinitesimaU
stain]) of gK'at reality. The autluir was thoroughly in earnest, and
]>n.S(:iitc(l to ud a ^ciml illustration of " tlie fervid genius of the
Scotcli." He (Dr. WyM) could not mhnit thatthe doctrine of infini-
ti'.siTiial.s,a.sproixjuniIe(n>y Dr. Ilaliuemann/' was unscientific, be-
cansf.' incoiiiprelieiisible." Many facta in science were, to the limited
nature of human thought, quite incomprehensible. The fact that
soniL' of the fixed stars werc millions of times larger than our
sun, whilst otlier stars were s<» tli.stant that their light took thou-
sands of years to reach our earth, \venj scientific facts quite incom-
prelK'nsible to the human mind. The counter fact that a million
of intricately organised beings, capable of propagating their race,
might be all present in a drop of water, was another scientific
fact lieyond our comprehension. The telescope and the micro-
scoix? revealed these truths to our sense of vision, and we in
wrjrrls say, that we know these facts ; still, they were facts tran-
scending our powers of full comprehension, and were, at least,
far more inconceivable than the fact that the most violent forms
of discfase could be controlled by infinitesimal doses of medicine.
Dr. Cockbum not only denied the reality of the infinitesimal
dose, but said it was even, if true, still unnecessary. But this
statement could be at once answered by referring to numerous
cases of scrofulous caries of the bones being cured by the 12th
and 30th dilutions of silica, a substance inert in its gross form.
Anyone who has had an opportunity of judgiug,*must know that
many cases of disease have been cured by our highest dilutions,
which remained uncured by allopatliic drugs, and low dilutions
of liomoeopathic medicines ; although it was true that the con-
verse was sometimes the case also. Many diseases run a natural
course, and the sceptic refers all our cures to this cause ; but the
most unanswerable argument in proof of the actual power of the
infinitesimal dose seemed to Dr. Wyld to be drawn from the fact
that constipation of the bowels was frequently produced by our
remedies when first taken by patients new to Homoeopathic
practice, and this without any change in their diet or regimen.
The discovery by Halmemann of the power of the infinitesimal
dose was deeply interesting and important ; although that great
genius certainly pushed this and some other doctrines into the
regions of absurdity, thus greatly retarding the progi'ess of the
greatest reformation ever effected in medicine. llie doctrine
might be one contrary to a priori reasoning and probability ; but
it was a doctrine proved to be true by the daily experience of
millions of educated and intelligent men and women throughout
the civilized world.
Dr. Russell said : While I admire the courage of Dr. Cock-
bum in coming up to London and boldly throwing down the
gauntlet in this Society, by aflSrming the astonishing proposition
Consistent with Reason and Experience ? 37
that the use of infinitesimal doses of medicine is opposed to
reason and experience, and should be abandoned from this time,
I can account for the amount of support his views have received
only by the iogenuity and literary ability with which he has
succeeded in supporting them. It would be out of the question
to attempt at this late hour to follow the author of this paper
through all the steps of his destructive argument All I shall
attempt to do is, to point out what I conceive the fundamental
errors of his process; other speakers have ably discussed the
errors of detail into which he has fallen. Dr. Cockbum began
by a historical statement t6 this effect : — Hahnemann's greatest
success was in the first nine years of his practice — i.e., from 1795
to 1804 This success was obtained from medicines given in
massive doses, not in infinitesimal quantities. After he had in-
vented (to use Dr. Cockbum's own view) his small dose, his suc-
cess abated ; let us, then, imitate Hahnemann in his better days,
and not in his worst. I confess I heard this statement with
perfect astonishment. To me it is perfectly new. I have read
all that Hahnemann ever published, and I have read and trans-
lated about sixty letters written to his most intimate friends. I
have read almost all that his early followers have written, and I
cannot recall a single expression that warrants such a statement.
I look upon it as a pure figment ; and how anyone besides the
author of this paper, who seems to have trusted too much to his
imagination for his historical facts, should endorse it, is to me
an almost greater surprise. Not only is it without the shadow of
support from any authentic record, but it is opposed almost to
possibility, on Dr. Cockbum's own premises ; for I understand
that gentleman to avow himself a staunch adherent of the law
of Homoeopathy, and to maintain that it is only by discovering
similars that we can successfully treat the sick. Dr. Cockburn
is a Homoeopathist — ^wishes to be considered such — and objects
only to the infinitesimal dose. Did it not occur to him that
during the years which he fixes as being the most successful of
Hahnemann's useful career, he had not above some eight or ten
medicines proved ? Does Dr. Cockbum really mean us to be-
lieve that, with a very few partially known remedies, Hahne-
mann effected more cures than after he had increased his phar-
macopoea tenfold by his enormous labour ? If this reaUy were
so, then indeed the life of the founder of our system — ^the life of
toil and privation he led for twenty years — ^was all spent in vain.
But is it so ? On the contrary, the testimony of Hahnemann,
the evidence of his disciples, the universal belief of aU who had
an opportunity of becoming acquainted with the facts, — all are
dead against the wild assumption of Dr. Cockburn. Indeed, it
seems to me that the strangest tiling about this strange essay i*
38 Is (he Dmtrine of InJiniUsimaU
its anaclirfjiiisin. It sliouLl have been published sixty years ago,
b'fon* tlioro was any accuiiiuhition of experience in regard to Uie
utility of small dosi'fl. To publish it now is to make upon us no
less ii tlfinainl than this : " Gt»nth»iiien," Dr. Cockbum virtually
says, " Voii an; all wnm^ — you are labouring under a delusion
— the HoiiKi'opathy which has grown up in this century, like
tliat iiii^'hty tree which spning from a grain of mustard-seed,
ami which uow spreads its boughs over the whole civilized
world, lias been wrongly practised. Give up tliis system of prac-
tice— I will demonstrate to you its insuflBciency — and then" —
and th»'n what ? Here he leaves us ; we are to put our boxes
into the fire, and to leave our patients to their fate until Dr.
Cockhurn excogitates a system of medicine which he can recon-
cile to his fancy of what ought to be, not to his experience of
what is. I call his paper an anachronism, and say it should
have appeared sixty years ago ; but this is not far enough back
to thrust it ; it ought to have appeared at least two hundred
years ago, for it is really the paper of a schoolman before the
time of Lord Bacon. Its fundamental doctrine is, that we are to
find out by our unassisted reason what ought to be true, and to
deny everything which does not square with our preconceived
notions ; we are to deny that there is any virtue in a dose of the
Cth dilution, because we do not understand how there should be
any. Such were the systems of philosophy before the time of
Lord Bacon. They were presumptuous and barren. His system is
more modest. He tells us to observe phenomena first ; to attempt
to explain these phenomena afterwards. Hahnemann was his dis-
cix>l(i ; he was contented to observ^e and to experiment. The
fruits of his observations and his experiments have grown into a
system of practice called Homoeopathy. All who practise this
system, whether they like it or not, are his followers, and to him,
I may say, we owe everything. While making this acknowledg-
ment, I do not suppose it can enter into the mind of anyone
that it is the intention of any rational man to imitate what he
considers the errors of the great master. Of this, now-a-days, in
this country, there is little danger ; for, strange to say, it seems
the fashion for some members of our Homoeopathic body — men
who owe all their reputation, all their influence, to the fact that
they adopted the system of medicine discovered sixty years ago
by Hahnemann, by him alone, and made practical by his
labours, and by the labours of his disciples — it seems the fashion
now-a-days to depreciate all his merits, and to exaggerate all his
faults. To read what some have written, and to listen to what
some say, one would imagine that we had now grown so wise as
to be ashamed of calling ourselves the disciples of Hahnemann.
For my part, I can only say that the shame I feel is, that I am so
Consistent vnth Reason and Experience t 89
tmwortliy of so high a distinction ; for to be a disciple of that
great man implies that one should devote his life to the labour
of patient investigation into the action of all substances which
contribute means of curing disease. Hahnemann in his own
person did more by his life of toil for the relief of humanity
than all who either helped or followed him in this path. In my
opinion, it is as impossible to exaggerate his services to medicine
and the human race as it is for us to equal them ; but there is
nothing easier than exaggerating the errors into which he fell,
and really the amount of merit of those who display their inge-
nuity and bestow their labour in pointing them out, seems to
me quite infinitesimal.
Dr. CocKBURN said : Mr. Chairman, at this late hour it* would be
impossible to reply to each individual objection made to the paper
read to-night. I shall take up the most important of them. Dr.
Hale objected to my second position — ^namely, that infinitesimals
were not demanded by the requirements of the organism. He,
Dr. Hale, granted that, as regards food, infinitesimals were not re-
quired for the nourishment and growth of the body ; but he was
surprised to find in this the nineteenth century that anyone could
say this in regard to disease. In endeavouring to prove that in-
finitesimal doses of medicine were required for the cure of disease,
he. Dr. Hale, unwittingly went on to show, from the microscopical
structure of our bodies and the theory of cell development, that
infinitesimals were necessary; but as medicines do not go to form
part of the structure of the organism, nor take any share in the for-
mation of organic cells, the infinitesimals required for this purpose
must be infinitesimal quantities of food — ^the very thing he
granted was not required. He also stated that the fact of there
being no analogy between health and disease was fatal to my
position ; but I had nowhere made any such statement that an
analogy of this kind existed. I had shown that, in regard to
health, the food required for the nourishment of the body must
in its constitution be similar to that of our own bodies ; that
in disease, the medicine to cure must be one which is capable of
acting on the body in a way similar to the disease ; and
that in these respects there was an analogy. Also, that in health
infinitesimal quantities of food were not required for the nourish-
ment of the body ; and that in the cure of disease, infinitesimal
quantities of medicine were not required ; and that in this re-
spect also there was an analogy. No argument had been ad-
vanced against these positiona Eeference had been made to the
wonders revealed by the spectrum analysis, but I can see no
support which these give to the doctrine of infinitesimals. And
^bearing in mind the lesson taught by Rutter's magnetoscope, I
think we ought to be cautious how we attempt to bob>tfcx >\^ ^
40 lb Ui€ Dm'trint of IiifinitmrnaU
doubtful doctrine hy such a novi-lty. While accepting the cor-
r«M;tii»'h.s of the analysis ciualitatively, I suspect there is an error
(Hiiiif'ctt'd with tliii caK'ulat ions, which guuu the assumption that
whi II oiK'piiin of c}iloiid(Mit*s«Mliuni is burnt in a room, the sodium
i^iwiko. Jiils the itioni. I «^n*ant that it maybe equally diffused
throiiijhnut tlie atnins]i]icre in the room ; but it cannot fill the
r<ioni without first nustin*{ the wliole atniosjiheric air present:
jin<l not only sn, Imt it wuuM n^quin^to oust the whole furniture
jir< -^i-iit. Tlic (|uantity of atmospheric air in the room, as well
as all th(r iurnitun*, must i-citn-scnt so much sitace where there is
IK) cliloride, it ])tMii|r imi»o.s.sible fur any two bodies to exist in
tli*i saiiK- sj)ace lit tin* sanui time. Fn»m all those experiments,
\\i)\\c\i:\\ it would a])pear that the chU»ride of sodium exists as a
con.*,taiit iii;jn*dii!nt in the atmosphere, in a quantity perhaps
i'.(\\\'A to our Snl or 4th potency, and that many other sub-
fttaij(;(:.s U-sidcs the chloride are also present. Look at the silica
conslaiilly tritunited on our footpaths and highwaj'S, driven by
til' J wiiid:^, and inhaled by everyone — look at the iron, the copper,
aii'i ilii;ziiic, from the ])euches of a thousand artizans, carried by
iIkj \,Ti'M'/A'.ii in eveiy direction — ^look at our <lrug mills, chemical
woilcH, i\r\\\!^ shops, and lalx)ratories, on every side of us, con-
Htautly prjurin;^ forth large quantities of powerful and deleterious
iiiat'rj'ial. Wliat effect can globules of the 30th potency have in
tij'; pKis^-nce of th(;se higher activities? Halmemann never
ilr*:aiijt of the siMH;tniin analysis ; but taking the drift of his rea-
bonin;( in coimecticjii with these potencies, there is not a shadow
ii\' a doubt that he looked upon the use and efficacy of these
pot^'lK:i'^s as Ixdiig in the highest degree inconsistent and incom-
patil)l<; will I the \)X<t^iiQ>Q of any disturbing agency in the
organism at the same time. And on this account he not only
institiitfjd a most rigorous diet, but insisted on the removal of
rivt^rytliiiig that could exercise any influence of a drug nature on
tlio Ixxly. I^ut while he could banish the coffee and the tea, the
tooth-powder and the perfumery, who could remove the chloride
of sodium from the atmosphere, or sweep away those other
nuni(;rous agents, the presence of which is now being revealed
to us by the sjjectrum analysis? When the facts become more
matured and numerous, I look to this mode of analysis as being
liktily to furnish us with a powerful argument against the use of
th<j inlinitesiinala Dr. Hamilton argued that there was an
analogy between the infinitesimals and the different miasms,
and that tlui power of the latter proved the power of the former.
I can H(U! no analogy here. Anedogy can be predicated only on
thri'c' grounds — first, analogy in regard to kind; second, analogy
in ivgard to (piantity ; and third, analogy in regard to power.
l-'iiMl., in n^gard io kind. As no one has ever succeeded in dis-
Consistent wUh Reason and Faperience f 41
-covering the nature of the miasms, we are not warranted in
assuming that anything else has any analogy to them in kind.
Second, in regard to quantity. We do not know in what particular
form the the miasms exist ; but, assuming that they exist in a
gaseous form, is it not reasonable to suppose that this gaseous
material is diffused through vast tracts of the atmosphere, and
that an individual exposed to this, inhales large volumes of it
at every inspiration ? Is there any analogy in quantity between
that and the supposed infinitesimal quantity of drug in a
globule of the 30th potency ? To me there seems to be a great
contrast. Or, supposing that the miasm exists in the form of solid
atoms, is it not reasonable to suppose that these are spread over
immense districts, and that a person exposed to it must inhale
millions and millions of these ? Is there any analogy between
that and the quantity of drug supposed to exist in a liliputian
globule of the 30th potency 1 There seems to me to be a pro-
digious contrast. Third, in regard to power. Is there any
analogy between the power of the pestilence that walketh by
noonday and that spreadeth abroad its terrors by night ; that
makes our homes desolate, and fills our graveyards with
blackened corpses — ^any analogy between that and a globule of
the 30th potency ? The very idea is absurd. My friend Dr.
Eussell has made a very full and elaborate defence of the doctrine
of infinitesimals on the general ground of experience. This
appears to me to be the stronghold of the doctrine ; but what
does it mean ? Is it meant that experience proves the efficacy
of all the potencies in all diseases ? No. Is it meant that ex-
perience proves the efficacy of ail the potencies in some diseases?
No : for many of the potencies have never been tried. Is it
meant that experience proves the efficacy of some of the poten-
cies in all diseases ? No. I take it, therefore, that it must mean
that experience proves the efficacy of a limited number of the
potencies, not amounting to a fourth of the whole, in a limited
number of diseases. But this is something very different from
that which is implied in the general objection. And then, even
though it had assumed this modified form, I should have sought
to know what it was that led to the choice of the special potency
in the special case : why it was that thirty was chosen in place
of twenty-nine or thirty-one ; why sixty was riosen in place of
sixty-one or fifty-nine; why, in a word, any one particular
potency was chosen in place of the one immediately above or
immediately below. The answer to this is vital in the case.
And I know that no one can give any rational, or scientific state-
ment as to what ought to decide the special choice. This being
the case, we would require still further to modify the objection,
which would stand thus : — That experience proves the effic*"
42 Is the Doctrine of InfinxtmmaU
a liniitod number of potencies, not amounting perhaps to a
fourth of the whole, in a limited number of diseases, and that
unfh.T c()n(iiti(ms and circumstances totally undefined and un-
dcfiiialjle. I can see no force in an objection like this. But
it ii])pears to mu we arc on very dangerous ground in making
our ap]K?al to experience. As Homoeopaths we have always
felt our superiority over our opponents, and been able not
only to refute every objection advanced against our system,
but, without any flattery, I may say we have been able
to vanquish our opix)nents; and this we have been able to
do solely on the ground that our mode of practice was based
on law and consistent with reason. But, in making our
appeal to experience, we lose our vantage ground, and place
ourselves on the very same level with every pretender and
empiric in medicine. Look to our HoUoways and Morrisons,
our Parrs and our Perrys — ^they all make their appeal to expe-
rience. I know that experience is the grand test and touchstone
of every system and every science, but in the doctrine of infi^
nitesimals we have no system and no science to which we can
apply the test. It appears to me that it is not possible that
experience can prove the efl&cacy of the infinitesimals, and for
this reasoa You will all agree with me that in every practical
subject in which a practical test can be applied, it is absolutely
necessary for the individual applying the test to make himself
thoroughly acquainted, not only with the nature of the thing to
be done, and to know that he can do that, but he must also
make himself thoroughly acquainted with the condition and cir^
cumstances on which the success of the experiment depends,
and act up to these. This is imperative in every science. Why
is it that we have been obliged to reject the experiments of
Andral as to the truth of Homceopathy ? Why have we been
able to refute these ? Not because Andral did not imderstand the
Homoeopathic formula; not because he knew nothing about
Homoeopathic remedies ; but simply and solely because the coii-
ditions and circumstances on which the success of every such ex-
periment depended were grossly violated in his case. And just so
here. The conditions and circumstances on which the success
of the potencies depends being unknown and undefinable, I hold
that it is impossible to apply a rational experiment in the case ;
and as no rational experiment can be applied, no one is wiEUV
ranted in saying that experience proves their efficacy. I shall
not say what may not be proved by empirical experienca
Though no rational experiment can be made with the infinitesi-
mals, we find that they are daily used, and there must be some
reason for it Infinitesimals can be employed only on three
grounds : 1st, on the ground of authority ; 2nd, on the ground
Consistent with Reason and Experience i 43
oi precedent ; and 3rd, on the ground of empiricism. The 1st
we have embodied in Hahnemann ; the 2nd in the earlier dis-
ciples ; and the 3rd in some of the present race of Homoeo-
pathists. 1st As to the ground of authority. Hahnemann's
experience has been divided into two sections — ^namely, his
earlier and later experience ; and from the far greater success of
the latter over the former, it has been assumed that he was war-
ranted in dogmatically teaching that the 30th potency was the
only proper dose always to use. There can be no doubt that
Hahnemann was successful during the first nine years, when he
practised Homoeopathy with large doses. He was not ashamed
of his success then, but from time to time published highly in-
teresting records of successful cases— cases which he believed
were calculated not only to prove the truth of Homoeopathy,
but which were likely to gain converts to the new system.
To an unprejudiced mind it is rather a suspicious circumstance
that he should publish no further records after the introduction
of infinitesimals. But successful as Hdmemann was during
the first nine years of his experience, we would reasonably
expect that he should be more successful in his later yearsL
We would expect at least a twofold increase of success. First,
we would look for an increase of success, as the number of reme-
dies increased ; and, second, as he became more fully acquainted
with the curative powers of the different remedies. And it
would be an interesting subject of inquiry to find out if Hahne-
mann's later experience actually came up to this requirement
I do not deny that it did. But it is assumed by some that we
have not only this, but that we have a threefold increase of
success by the introduction of the infinitesimals. It is this
assumption which I call in question ; not a particle of evidence
has been adduced to prove the truth of this. That the extensive
records which he collected for forty-three years after the intro-
duction of infinitesimals do contain a great amount of material
which would be of great importance to Homoeopathy, I do not
doubt ; but that these records refer to diseases more deadly or
more dangerous in their character — ^that they refer to cures more
striking and more rapid — or that, in a word, they contain evidence
more convincing and more demonstrative of the truth of Homoeo-
pathy than those published in '96 and '98, 1 cannot believe, and,
considering the importance of the assumption, and inference to
be drawn from it, I dare not believe without the most unequivocal
proof. However much anyone may differ from Hahnemann on
some minor points, no one can for a moment doubt his sincerity, or
imagine that he would leave one stone unturned that was likely to
advance the cause he advocated. But to say that he had in his
possession for upwards of forty years such a mass of material*
i' •
...'
I"*
t.',:
i '.\
ti''ti
:.'iji
lit,'-
i' '
).'■
4 i In tht Th^.trxM of Infinittsimah
^'.f. *:...::.;' t}j;,t. v'Tv fvuh-Tiff' iijirm which the conversioii of the
ifi! t|j" j.nff-riori to thf; faith auil practice of Hoxnoeo-
r.;:.:i!v 'Ji|.<rifl<rrl, nii'I tlint yet he withheld the publica-
t}i;iV i-i «*j*ji'i-*i| to fill I'vjili'iicp. I can look upon Hah-
I .1 - \f\u*j ;iri hoiif.st man, and reconcile the fact of hia
!; lijii:.' tli< .<• vtuiiX^ only on the understanding that, as
' ^:[j' v.- -aIi;.! tli* y r r,ijtaiii»-d, h«* n-ally lx?lieved that their
J. .'... I'.'iii -Aoul'l [j'jt. In- fi»r tli<: lif-nefit of Homoeopathy. I can
\'utv\',\f -.w- no ;ii;.'inij'ijt in favour rjf tlie infinitesimals that
t '.lu \,*' '\ii\Au \vu\\\ Hiiliii'inainr.s later exx)eriencc. Second, as
f/» W.f '/\',\\ut\ of [in-n-di'iit. Some Ifoniri'opathists are con-
;t;M.t;v ;,...../. riiii;# tJi;it the f-arlier di^H;ilJ^*s were more successful
t}i;iji \\\',\t\ now living' are; hut no pniof has been given for this
u\'.i\Uttu. I \}t'\\i:\i\ it is jMin'ly apocryphal. God forbid that I
^■.lionl'l ■■.;iy one word (liMpani«(in;4ly of those noble men; we are
fill intiiWy iu'lebtird to theia I lionour them for their work's
wik<', aM'i, w' re they now jiresent, would most heartily sympa-
i\iy\i\ with them in tiie Huffcriui^s and pei*secutions which most of
th'-jM rriMMt, have unrh'i-^one in tlie defence of the truth. But
fojfiid that any of uh sliould substitute either a Paul or an
Apollo:', ill t.hr; jilace of truth itsdf. Tlie assumption that the
i'iuVM'Y i\m'\\ih*H were more Hncee.ssful than we are, and the infe-
renri! drawn then^from, I eannot but look upon as an unfortunate
atU'Mijit, to im|HiHe u|K»n uh tlic: doctrine of individual authority
in thi* \}\\\v.i\ of I^iw and ilij^dit. Tint I trust that all who know
whdt, Lnw nnd Hi^dit mc'an, and who feci the moral obligations
nnd*r whicJi tJii-y lie to thcHo, sliall resist every attempt to
hav«' iirijiofwd upon them any otlier higher authority. Thiid, as
to th*' j^, round of (MnpiricJHm. The essential difference between
llonio(»|»nihy and Alloi)alhy lies here, — ^tliat in Homoeopathy
ihi'n- \\s a law, by the jrui<hinee of which we cAn, with confidence
and ccrlainty, eome to a knowled<^M». of tlie tnie curative remedy
in any curable cane. In Alloi)athy thei'e is no such law; but in
\\\\\ alificncn of Uuh Mich! an? c.ei'tain rules and guides which we
nmy I'ornialirtct aH Mm theory of nh vsus in morhu The theory of
ah it.'iitnin vinrhi, and the law w/nVm smi7/6w5, constitute the
diHliiM'Mve liadj^i'H of the two o])posing schools. The practical
applieatiou of the ironinM)])athic law, in so far as the choice of
the remedy \h concerned, is unity and harmony ; the practical
applienfion of the Allopatliie theory is disunion and contradic-
tion. And wo hold that, ho long as tliis false theory is acted on,
we can have nothing but contradiction and disunion. But aUthis
rout nidiet ion and all this disunion we attribute not to any want of
skill, not to any want of knowleilge, not to any want of sincerity
ow the |Mirt of the individual practitioner, but we trace solely and
lUnvtly to the inherent llaUacy of the theory. But while the
Consistent with Reason and Experience 1 45
Allopath chooses his remedy by the false theoiy of db usm in
morbi, the Hahnemannian Homoeopath chooses his dose by the
very same theory ; and all the disunion and all the contradiction
that prevails in Allopathic practice is thereby introduced into
the practice of Homoeopathy, and I fear very considerably
intensified. And it cannot be otherwisa A theory which is in its
very nature fallacious, can never change its character to ac-
commodate the particular fancies of any sectary. If observations
made upon the sick constitute a true and a safe guide in medical
practice, then let us be honest and say sa If so, we must cease
finding fault with the Allopath for being guided by this. But
if these do not constitute a true and a safe guide, then let us be
consistent and abandon it. The spirit of Homoeopathy demands
this. Homoeopathy has to do with law, with ascertained natural
phenomena, and not with empirical experience. In Homoeopathy
we believed we had found a system which was based upon law
and consistent with reason. And having done so much and
suffered so much in behalf of our cause, shall we now introduce
into our theory and practice the very error against which we
have so strenuously and so successfully protested ? Are we now
prepared to confess to the public and the profession that while
we have a law to guide us in the choice of the true curative
remedy, we have nothing but empirical experimentation on the
sick to guide us in their application? Forbid that this ever
should be so. Hahnemann has taught us the true use of em-
pirical experience, by making it subservient to the development
of some grand general principle. He seized hold of the em-
pirical experience of the past, and made it instrumental in sub-
stantiating the truth of the discovery he had made. Let us
follow his example, not by becoming empirics, but by using the
experience of others, and our own also, in the development of
some great general principle for the regulation of the dose.
This is our task. Hahnemann discovered the law which guides
to the choice of the right kind of medicine ; it is for us to dis-
cover the law which guides to the choice of the right quantity.
Let us strive to accomplish this.
Dr. Chapman (in the chair) : We are much indebted to Dr.
Cockbum for coming such a distance to read his paper to us, and
the more so as this is his first visit to London. We also con-
gratulate ourselves on having a man among us of such ability.
He is a brave and bold man, too, to assert in this Society of
Homoeopathists that the doctrine of infinitesimals is inconsistent
with reason and with experience. His mind, it would seem, has
a greater tendency for metaphysics than for physics. Is the
doctrine of infinitesimals inconsistent with or opposed to Eeason?
What Eeason, or the reasoning faculty of what individual, does
46 h (he Doctrine of InfinitmmaU
tlio in^'oniuus autlior rcTor to? One man's Reaaon, or what he
supjioscs to l>e such, diflVrs from another's. The highest Season,
in its infijiit«^ chanictur, is unapproachable by us. The highest
reasoning; faculty of any ^ift<Ml human being is far away firom
th(* (.'oiiiprchcnsion of tlit^ i^reat bulk of mankind. It is a thing
reiiiott*. like some " brij^ht particuhir star." Who of living men
has souniltMl the (Io])tlis and shallows of Kant's logic? How
many or the numerous mathematicians of the world have
mastVrcrl the subtle analyst^s ^ of Nt^wton and La Place t No
man has a ri^ht to say — "Sic vcdo, sic juIkjo; stet pro ratione
voluntfis." — (" I am Sir Oracle, and when I speak let no dog
bark.") It comes to this, that the doctrine of infinitesimals is
inconsist(.'nt with the reasoning faculty of the author of this
essay ; but it is a non sequitur to assume, therefore, that it is
inconsistent witli pure reason, with pure logic. All that is
worthy of the name of science moves in the direction of this
doctrine. The " infinitesimal increments " of Newton, the "atomic
theory " of Dalton and the advanced chemists, the discoveries of
the great Dane Oersted in reference to light and electricity — ^the
wire that flashes a message over half the globe — are iUustia-
tions of the infinitesimal. The Infinite uses infinitesimals ia the
creative, conserving, and re-constructing exercise of His autonomy^
and autocracy. This doctrine, which Dr. Cockbum laughs to
scorn, not only pervades with its golden threads all true science,
but also all nature. You find it in the scents of different
flowers, in the colours of the shells of the shore, in the infini-
tesimal difference between the constituents of an active poison
and a harmless thing, as in the bitter and sweet almond, the
bitter and sweet cassava. The doctrine of infinitesimals is the
very key-stone of true philosophy. Dr. Cockbum also laughs to
scorn the analogy between the atoms that spread plague and
pestilence, and the atomic doses of medicina There is nothing
whatever to laugh at, for the fact remains. A single drop of
water in a part of the brain where no water should be, has
before this extinguished the brightest faculties of the human
being. An atom will cause disease, and kiU. It is clear, there-
fore, that the doctrine of infinitesimals is not inconsistent with
Eeason. Passing from the higher logic of pure and abstract
Reason to the "logic of facts," a very inexorable thing, we are
startled by another thoroughly imwarrantable assertion of Dr.
Cockbum — ^that experience is without value — ^a dangerous thing
to appeal to or to rely on. Bacon, who dedicated his great
works to posterity, observed that Time, which blots out opinions
and comments (the figments of Dr. Cockbum), confirms and
establishes experienca Is experience to go for nothing, because
our estimable and able colleague so wills it 1 Hippocrates has
Consistent wUh Reason and Experience t 47
been mentioned. On what does his r^utalion rest ? On his
admirable clinical observations, as fresh and as valuable to
those who can avail themselves of them as they were two
thousand years ago, when Pericles "lightened and thimdered "
over Greece. On what does the reputation of Sydenham rest ?
In like way, on his admirable clinical observations. Our
essajdst has spoken somewhat slightingly, and so irreverently, of
our founder. Samuel Hahnemann. He says, "Hahnemann
discovered the law of Homoeopathy, and invented infinitesimals."
Hahnemann, in point of fact, did not discover the law of Homoeo-
pathy, nor did he invent infinitesimals. In one of the writings
attributed to Hippocrates, it is distinctly stated that some
diseases or disorders are better treated on the doctrine of
" similars," and others are better treated on the doctrine of " con-
traries." Suetonius, in his " lives of the Twelve Caesars," stated
that the Emperor Augustus was unsuccessfully treated ac-
cording to the law of Similars, and was cured according
to the law of Contraries. In the introduction to his " Organon,"
Hahnemann accumulates proofs that the law of Similars had been
more or less recognised through all the cycles of genuine medical
history. With his prodigous learning and his insatiable in-
dustry, he collected an immense amount of facts ; he brought
them all to the test of the law of Similars, and found all were
included under that law. like a man of true philosophical
genius, he came to his conclusion, and proclaimed the law of
Similars as the law of drug-heali'tig. This was quite irrespective
of dose, and brings us to Dr. Cockbum's charge, that he invented
infinitesiToals. As infinitesimals have always been, from first to
last, he could hardly have invented them for his therapeutics.
Hahnemann attended a patient with severe cholera before the
irruption of Asiatic cholera from the Delta of the Ganges. Ac-
cording to his law, he gave her veratrum. She nearly died from
intense aggravation of her disease. He was a thinking man ; he
had some experience, and a magnificent reasoning faculty — so
he reduced his doses, and, by gradual stages, got to his infinitesi-
mals. The continued reduction was with him a matter of expe-
riment. Dr. Cockburn has asserted that Hahnemann, during
his first nine years of practice, while he was supposed to use only
crude doses — ^not the slightest proof adduced — won his reputa-
tion, and that it thereafter became " small by degrees, and beau-
tifully less." Not the slighest proof of this very rash assertion
has been produced. The fact is quite the other way. Hahne-
mann never published more than three cases. Dr. Cockburn,
without saying whether he believed in mesmerism or not, im-
plied that Hahnemann was a powerful mesmerist The few
pages which he devotes to this subject in the " Organon " show
that Hahnemann had not really paid much attention \a^ tcl^^-
48 Tx the Doctrine of Infinitcsiinah
iiifrisiii. Dr. Cocklmrn has sneered at aggravations for high
dilutions. A Live]*|>ool merchant consulted Dr. Chapman. He
g;iv(; him two or three globules of opium 30. The x>atient did
not know what he had Uikcn. He canio the next morning, and
Siiid, '' You gave me o])ium yostenlny, and I suffered the worst
o]>iiini symptoms/' wliich he gra])hically described. A relation
of th(; Cliairman was subjc^ct to violent and even terrible tetanic
conviilsi(;ns at the times of the catamonial period. She despised
Homoeopathy, and said there was nothing in it He was on a
visit to her, and sh(i had the forewarning, one night, of one of
tln*se attacks, and she said to him, " I will try your nonsense."
She had two or three globules of belladonna 30. She was gene-
rally confined to her bed-room several days from the conse-
cpiences of this sort of attack. She had no notice of what had
been given to her. She, contrary to all expectations, was at the
breakfast table the next morning, and at once said, "You gave
me belladonna last niglit. Dr. Baron (the biographer of Jenner)
gave it to me some years ago, and he told me he gave it to me
in sncli a dose as he would give to a baby. I was horribly dis-
tnisscd. The dose you gave me last night produced the same
results. I would far rather suffer the torture of the tetanic
misery than that of belladonna. I was seeing the figures of
naked men all the night long." Tlie lady wheeled about. She
no longer laughed at Homoeopathy, but she says we use only
subtle poisons in very concentrated forms. He (the Chairman)
thought that Dr. Cockburn's argument had entirely failed.
To use the Cambridge phrases — cadit qicocstio, cadit argv/nun-
turn. The real fact remains, that the doctrine of infinitesimals
is thoroughly consistent with reason and with experience. I
hold, in conclusion, that the dodmiie of infinitesiinaU is tho-
roughly consistent. Dr. Cockbum's paper, however, will do
good — has done good — for it shows the gross drug-givers
that they are dmfting into Allopathy. We have present this
evening those who use gross doses and those who carry their
prejudice in the other direction — to only reinote injinitesimals.
All extravagances perish. We must not relinquish accurate
observation and large experience for the pursuit of a phantom,
born of the crude fancies of a metaphysician. The experience of
HomoDopathists in general during the last sixty years is worth
infinitely more than crude assertion or idle theory.
Note by Db. Cookbuhn.— The subject introduced by Dr. Hale is contained in
one of the portions omitted from this printed report of my paper. The argument,
however, essentially was this — the Ipecncuan in the illustration I gave was actaally
present in the attnosphere, and did actually produce drug symptoms; this was sot
denied. But while this, and aU sncli like cases, proved that very small qnantitiai
of the material drug did act, no amount of such cases could give any support to
the idea that the 30lh potency of the same drug had any effect, or, indeed, that it
contained any of the drug at ful.
49
ADDRESS OF THE PEESIDENT, DR. QUIN,
AT THE
ANNUAL ASSEMBLY OF 1863.
Gentlemen, — The British Homoeopathic Society has now
entered the twentieth year of its existence. During the whole
of this period I have been honoured by your repeated election
of me as your President, and until within the last two years I
have hardly ever been absent from one of the Societ/s
meetings; latterly, however, from fedling health, I have been able
to attend but very irregularly, and I have felt great scruples in
continuing to occupy the chair. Had I listened to my own
wishes, I would have resigned some time ago, or, at least, have
begged, when the annual election of the ofl&cers of the Society
came round, that a more efficient President than myself should
be chosen. I have refrained, however, from following my own
inclinations in this respect, at the request of my colleagues in
ofl&ce, who, in their kind partiality, have repeatedly expressed
their opinion that the interests and welfare of the Society
would be best consulted by my abandoning my intention of
withdrawing from the Presidential chair. I candidly confess that
I have had less scruples on this point since the election of our
present most eflBlcient Vice-Presidents, Dr. Chapman and Mr.
Yeldham. The able manner in which they have presided at
your meetings, and conducted the affairs of the Society, have
left nothing to be desired ; and I have seen with pride and
satisfaction the ability, eloquence, and practical knowledge
with which our Vice-Presidents have taken part in your dis-
cussions, and summed up at the close of the debates, as recorded
in our Annals. To-morrow evening the election of the oflBlcers
will come on, and I earnestly beg that you will not, from
feelings of false delicacy, have any hesitation in electing another
President to succeed me — one who will more efficiently per-
form the duties of President than I have been able to do of late.
VOL. ni. 4
50 Address of the Ptrsident.
I Hincf^TfAy congratulate you on the increasing number of
your iii^rmlieTS, and on the increasing utility of your labour&
TIj'.' aiitiriiifitions and prophecies in which I indulged on the
i'ii\ frl«';tion of our prt'seiit able and energetic Honorary
.S<;cr<;lary have l^'On fully fuliillwl. 15y his active influence and
uir,y*:ixjit:(l industiy, the number of essays and papers have so
gnratly increased, that the Society is now able to meet t^'ice
inhV:iA of once every month in the session, — thus your
Tn';';tings have not only gained in number but in importance
and usefulness, whilst the publication of the Annals of the
Hof'/udy are spreading far and near, not only the information
contained in your practical and theoretical papers, but also that
contained in the valuable and practical debates which these
pafy^rs give rise to. We have a flattering and convincing proof
of thi/j in a letter lately received from Dr. Meyer, editor of the
JlorruxopaihiscJie Zeitung, and Physician to the Leipsic Homceo-
pathic Hospital, in which he says, " I have received a copy of
tlie last number of the Annals, and have already made arrange-
ments to have one of the papers translated and inserted in my
journal I will have much pleasure in sending you my
* Jietrosj>ect of the Year 1862 ' as soon as it is published, and
shall r;ertainly make favourable mention of the Annals in it
I have read the last number with great interest, and am
much pleased with the earnestness of the discussions, but
I lament that it is so much the custom in your father-
land t^i give the medicines alternately, consequently making
exa/.'t oV;s^;rvation very difficult. Could no means be adopted
to aUjiish this vicious habit?"
The testimony of so distinguished and learned a physician to
the utility of the Annals, and your discussions, cannot fail to be
gratifying to you. I have so often endeavoured to impress upon
you my opinion of the erroneous practice of alternating medi-
cin<;s in quick succession, before the sphere of action of any of
them can have terminated; and I have so often tried to inculcate
the a/lvantagc of more simplicity of practice and a stricter
Address of the President. 51
adhesion to the principles handed down to us by Hahnemann,
that it is not necessary for me now to say more than that I
thoroughly agree with Dr. Meyer, and heartily reiterate his
wish to see this practice abolished in England.
With regard to the papers read before the Society, I strongly
recommend to the serious consideration of those members who
may hereafter write papers, to send a resfwrn^ of them a fortnight
before they are to be read — ^to lie on the library table, to be
perused by their fellow-members, before they are discussed. I
am certain that the debates will, in consequence, increase in in-
terest and in importance, and reflect more honour on the gentle-
men who take part in the discussions. In the early days of the
Society, two copies of every paper were made and circulated among
the members during the fortnight preceding each meeting. The
result was most satisfactory with respect to the tone, character, and
value of the debates. With these preliminary remarks I shall
now, with your permission, proceed to notice the papers and
discussions of the session just closed. From the cause stated
above, I am sorry to say I was not able to attend many of the
meetings and join in the debates.
The session began in October, with a paper by Mr. Brisley,
entitled " On the Advantages of Alternating the Higher
and Lower Atteniiaiions of Medicines in the Treatment of Causes
of Chronic Disease*' — a most praiseworthy endeavour to im-
press upon the attention of the Society one of the principles
laid down by Hahnemann, but too often forgotten now — that
we should be extremely careful in the selection of our reme-
dies when we commence the treatment of any chronic case ;
and that after we have made our selection, we should not
capriciously give up one remedy for a new one, until, at least,
we had satisfied ourselves that the medicine of our choice had
no beneficial action in the case, either in a high, a moderate, or a
low dilution. It also illustrated an important fact which I
have repeatedly mentioned here — ^that if we wish a medicine to
act beneficially, and for a long time, we shall often act wisely
4*
52 Address of the President.
to prescribe it in various attenuations, ninning the gamuts as it
\^'cre, from the lower to the higher attenuations, and again
reversing the order from the higher to the lower, so as to afford
the organism a choice, so to speak, of every modification of the
medicinal substance prescribed, and not pall its appetite by the
constant repetition of it in the same strength and dose.
Dr. Drury followed with an interesting paper upon some
cases of sudden and alarming illness, which might, in certain
circumstances, have given rise to suspicions of poisoning. The
subject was, and is, one of great imi)ortance in the face of the
startling evidence given by a great medico-legal authority of
the great number of cases of poisoning which are undetected.
It would be well if, following the example of Dr. Drury, a care-
ful record were made of all the cases of sudden death which
occur in the hands of every practitioner. We should do some-
thing to allay the unwise panic, and often unjust suspicions^
when such an event takes place ; and by a careful investigation
of the causes of such dreadful catastrophes, we might do some-
thing to avert some of them.
The next paper was by Mr. Harmer Smith, " Upon the JEm-
ployment of AvjxUiaries " — ^an attempt to lay down certain
general rules for the guidance of practitioners. As this subject
was also incidentally handled by Dr. Hilbers, I will reserve
any observations which suggest themselves till I notice his
paper.
I have now to record a most interesting paper **0n the Treat-
ment of Ovarian Tvmou/rs,'* by Mr. Leadam. Although the
title was thus general, the paper was apropos of a case of
ovariotomy. The operation was performed with great skill and
steadfast coolness by Mr. Ayerst, and after the life of the
poor woman had been several times despaired of, in conse-
quence of the violence of the enteritic symptoms, she even-
* tually recovered. This case is very instructive, both in the
way of warning and encouragement, and it is highly satis-
factory to find the uniform and universal testimony of aU
Address of the President. 53
who have had opportunities of obBenration, to the skill and
success of Mr. Ayerst as an operating suigeon. We are now
no longer dependent upon the caprice of the suigeons of the
old school, and, as they have thought proper to turn their backs
upon us, they cannot be surprised if we should now, and in
future, content ourselves with such aid as is obtainable in the
increasing experience, skill, and dexterity in operating, of mem-
bers of our own body.
Mr. Leadam's practical and instructive paper was followed
by one of a more ambitious character, from the pen of Dr.
McGilchrist, of Edinburgh, entitled, " Is DipMheria a Specific
Disease i '* It is evident that the writer of this essay has been
long trained in the art of composition. It has the merits and,
perhaps, some of the demerits of a merely literaiy articla It
is ingenious and erudite, but the arguments and illustrations
bear a larger proportion to the positive observations than is
usual in a paper submitted to our body upon so intensely
practical a subject as diphtheria. However, such well-written
essays have a use of their own kind, and it is weU for us that
in our body we have so great an infusion of literature.
Dr. Ozanne, of Guernsey, followed with a paper " Upon some
Cases of OphtJialmia" As he sent it merely to stop a gap
at a former meeting, and as he was then prevented firom com-
pleting in time the essay which is to be read to-night, and of
which the account of the cases I have alluded to evidently
forms a part, it would be premature, nay, unfair, to make any
observations upon it beyond the obvious one, to all present,
that it is sure to be replete with practical information, and give
evidence of careful investigation.
The next paper, or rather communication, was by Mr. Daniel
Smith, in which is narrated an interesting case of fever, which,
although at one time it appeared likely to have proved fatal,
by the judicious treatment it received, eventually recovered.
It is encouraging to young practitioners who may be disposed
to despair of the recovery of their patients in apparently des-
perate cases.
54 AilJnss of the President.
In the same month, Dr. Marston. of Devizes, read his elabo-
nitr rssay, " On the Phi/8iolt}ffy ami Patholoffy of the Ganr
I// inn if St/sfnn of Xirrvs, dnusidered in Especial Melattan to
IlnttHi'fpfffhic ThrajKuticny It is well that we should have
sue h sulijrcts ])rou;:ht belore us from time to tima There is,
un<l<)ul)tc(lh% a ri»k of our becoming so absorbed in the en-
gi-ossiiig details of the ]^ractico of IIomaK)pathy as to n^-
Icct vi«*wing the general therapeutic law, which guides us in
its i-cliitiou to the constantly iluctuating and frequently ad-
vamiiig sciences of physiohjgy and pathology with wliich it is
intimately connecteil If, however, we were to shape our practice,
nut upon the well-established observations recorded in the works
of Hahnemann and others who have assisted him in ascertaining
the positive pathogenetic, and therefore curative efiTects, of medi-
cines, but upon the speculations of physiologists and patholo-
gists, wc should very soon find that we had returned into the
delusions from which Hahnemann's genius and industry had de-
livered us. That a know^ledge of pathology may be, and is, of
the greatest advantage to the practitioner of homoeopathy, is
almost a self-evident proposition, and the successful and bril-
liant career of those who have been celebrated pathologists
among us is an illustration of the fact, if it require illustration ;
but it is one thing to enlighten our Homoeopathic practice by
a profound pathology, and quite another thing to attempt to
build up a wholly new system of practice on the assimiption of
the truth of novelties. I, for one, feel myseK called upon to dis-
claim any participation in such innovations, or approval of the
novel and immature system of practice arising out of them, which
is not only subversive of the fundamental propositions and well-
considered plan propounded by Hahnemann, and successfully
followed by many thousands of his disciples throughout the
globe, but fraught with danger to Homoeopathy as a practical
art, by substituting pathological conjecture for the well -ascer-
tained facts, the result of oft-repeated experiments, both patho-
genetic and clinical, extending over a long series of years. Let
inc not be misunderstood. I am quite alive to the great advan-
Address of the President, 55
tage of a sound application of physiology and pathology to
assist the Homoeopathic practitioner in forming a correct diag-
nosis of disease, and, in common with the Society, I shall
always hail with satisfaction all well-directed efforts which
have for their object the development of Homoeopathy and the
improvement of our knowledge of the action of medicines, and
of the indications for their judicious employment in any given
case; but it is only by long and persevering inquiry, oft-
repeated and careful experiments, and patient investigation, free
from all bias or predilection for preconceived theories, that a
claim to serious attention can be admitted when the doctrines
and practice taught to us by Hahnemann are sought to be
departed from and overturned.
The paper " On Local Anaesthesia," by Dr. Cronin, jun., has
the merit of being a short and dear statement of his own
observations and experiments upon a subject of considerable
and increasing importance ; and it is desirable that he should
continue his experiments and observations, as they cannot fail
to increase in interest, and probably be of assistance to us in
alleviating the sufferings of our patients in cases attended with
acute pains.
Dr. Cockbum, of Glasgow, next read his essay, or rather
treatise — for even, in an abridged form, it deserves from its great
length the latter appellation — entitled, " 7s the Doctrine of Infini-
tesimals Consistent with Reason and Experience t " This ques-
tion he takes upon himseK to answer in the negative. Nothing
can better demonstrate the liberty of speech we accord to our
members, than the attentive hearing accorded to the reading of a
paper, the tendency of which is to overthrow the whole system
of practice to which our lives have been devoted. The paper has
many good qualities ; it is a work of mind ; the author has be-
stowed much labour upon it, and prepared it with great care. Had
he given as much attention to facts as he did to arguments, he
would, in all probability, never have written it. It is evidently
the production of a physician who is isolated ; who has little
5<) Ailtinss of the Vrfmihnt.
iiii;iii< nf rniniiiiiniiatioii, little interchange of opinions, with
lii> t« Il«i\v-|iiii(titiniitr3; anJ ft*\v, if any, op{)ortunities of seeing
aii'l watrhiiiLj the nsiilts of the practice of men of far longer
(xjM li. II. f than hiiiisilf in Ilnnidopathy. Hence the narrow
< in 1.. ill whirh his \'w\\A of tlie action of minute doses of medi-
( iiif IIP- (iiiitiiuil ; an<l \w. <h»e.s not i>erceive that the circum-
scrilM-.l n|iiuinns cntrrtain^Ml hy liim are at variance with expe-
ri<iM«', aii'l that th<* puhlic-ation of thcni cuts the very ground from
un«l< r liis f»M-t, uj»ou which an* founcU'd the facts which led to
his rnii version ; for IIoniM-opathy spivad all over the Continent,
ami i»i«'nc«l into Ch-cai ]»ritain, and diffused itself all over Ame-
ri< a hy the very infinitesimal dose.s, the belief in the efl&cieneyof
wliicli, ]\(\ states, is inconsistent witli reason and experienca The
author must liave felt, as the discussion proceeded which arose
after the reading of his paper, how even those who most opposed
his o])inions still respected his honesty of purpose. It is deeply
to he regretted that he and some who joined in the debate
have not shown as much consideration for Hahnemann. Let
young practitioners remember that absence of reverence is no
sign of greatness of intellect, — quite the reverse. The lower
we descend in the scale of being, the less of this quality do we
find ; and the more we ascend, the more do we meet with it
A mouse, an oyster, a flea, have no reverence for a philosopher ;
but a philosopher has a reverence for a mouse, an oyster, or a
flea. It would be a work of supererogation for me to attempt
a panegyric of Hahnemann in this assembly. His labours to
increase our knowledge of medicine, his untiring industry, his
valuable experiments extending over a number of years, his
great erudition, his genius, are too indelibly impressed upon us ;
and our gratitude is too deeply rooted in our hearts to require
that I should dilate upon his merits.
Let us examine how far the author is borne out by facts in
the statements he has ventured to make. Dr. Cockbum fixes
the year 1795 as that in which Hahnemann discovered the
Homoeopathic law ; and he tells us that his greatest success
Address of the President 57
was obtained during the next nine years — ^that is, from 1795
to 1804 ; that it was his success at this period which gave
him his renown; and that the reason of this great success was,
his giving medicines in large doses. Let us see how the histori-
cal facts square with this hypothesis — for it is nothing more.
Where was Hahnemann during these nine years ? He spent
them in the following places: — In 1795, he went to live in
the small town of Wolfenbeuttel ; soon after, we find him in
another insignificant place — Konigslutter ; he remained here till
1799, that is four years only. In the year 1799, when, accord-
ing to Dr. Cockbum, he was in the blaze of his popularity and
reputation, he went to Hamburg, but he did not remain there,
because he had nothing to do ; and the same year he went to
Altona. He remained there for a very short time, and removed
to MoUen, in Lauenburg; thence he went to Eulenburg — thence
to Machern — thence to Dessau — thence to Torgau, where, in
the year 1806, or two years after the date assigned by Dr.
Cockbum and those who endorsed his statement, he published
his first sketch of the Homoeopathic system — " The Medicine of
Experience^' in an Allopathic Journal So that in these nine
years, when his success, according to Dr. Cockbum, made him
so popular, he had lived in nine different places, most of them
utterly insignificant !
Let us now see how far Hahnemann's own testimony and
practice contradicts the extraordinary statements respecting him
made by the author of the paper.
Dr. Stapf was one of his most intimate friends and earliest
disciples. The letters Hahnemann wrote him were strictly
confidential. In some of these he directs Stapf how to treat his
daughter, about whom he was very anxious, and of whom
Hahnemann was evidently very fond. Can we have a greater
test of Hahnemann's sincerity than shown in the tenour of these
directions? Does he recommend massive doses, frequently
repeated? (see p. 75 of No. VII., March, 1862, of Annals) : —
" It seems to be doing well now with your dear daughter, yet
58 A tidress of the PrendetU,
it will In3 nccossary that tlie Phosphorus should be allowed
to continue its ofTcct for sixt(»on or eighteen days." This is
in Si'|)tt'nil>or, 1827. In .January, 1829, he writes (see
]). 140 of Annals) : — " Altliou^li the winter is unfavourable to
an anti])soric courso, yet I tliink ]Miss Eliza will continue to
inij)rove. You have given her a dose of Nux Vomica; but
should the next catanieuial ])eriod occur at the right time, you
may pr«;teniiit the dose. You may, however, give her the dose
of Zincum on the 20th or 21st of January with confidence;
afterwards we shall see what is to he done."
His practice was strictly in accordance with his precepts as
given in the Organon : to select a medicine with the utmost
care — to give one dose, generally of the 30th dilution, par-
ticularly when prescribing any of tlie heroic medicines, and not
to repeat it till it had exhausted its effect, or to dilute it with
water and distribute the dose in spoonfuls over a given number
of hours, days, and sometimes weeks. He published no cases
after he had thoroughly made known his system, except three
in the Preface to one of the volumes of his Materia Medica
Pura, and these cases only for the purpose of illustrating his
method of selecting his remedies. His answer to Fleischmann
is worthy of record here, as exemplifying the mode in which a
case ought to be studied, and the appropriate remedy chosen.
Fleischmann, when yet an imbeliever in Homoeopathy, suffered
from sciatica, and having exhausted all the ordinary measures for
obtaining relief in vain, wrote a statement of his case to Hahne-
mann, who replied to this effect: — "If you study the symptoms
of such and such medicines as given in my Materia Medica^
you will find what will enable you not only to cure yourseU^
but others also." Fleischmann did as directed, discovered the
remedy for his sciatica, and convinced himself of the truth of
Homoeopathy, and of the trustworthiness of Hahnemann's
provings.
The actual time of Hahnemann's European celebrity did not
Address of the President. 59
really commence till after the year 1810, when he had pub-
lished the first edition of his Oiganon ; it went on increasing
until 1843, when he died. He never went back to laige doses.
To this fact I myself can vouch. I first studied under Hahne-
mann in 1826, at Coethen — I again went to him in 1828, and
again in 1831, still at Coethen. When he removed to France in
1834, I went there to meet him, and was present at the Great
Congress of Homoeopathic Physicians assembled in Paris to do
him honour, and to welcome him to France ; and I repeatedly
went over to Paris to see him during the remaining years of his
life. During these years, besides the many instructive con-
versations I had with him, I had frequent consultations, both
verbal and by letter, on many cases of interest or of danger,
and I can bear testimony to his consistent advocacy for
the emplojTuent of infinitesimal doses, and to the eminent
success which attended his treatment of the most complicated
and serious diseases occurring in individuals of every nation and
of every clime. During the latter years of Hahnemann's sojourn
in Paris, our colleague, Mr. Hugh Cameron, had similar and
frequent opportunities of conversing and consulting in some
most serious cases with Hahnemann, and he will vouch for the
foregoing facts, and bear similar testimony to me respecting the
opinions, practice, and great success of Hahnemann's treat-
ment.
It is with wonder, sorrow, and astonishment, not unmixed
with indignation, that we, who had the honour and advantage
of repeated and intimate communications with our great master,
and who listened with grateful reverence to the words of
wisdom and valuable practical precepts that dropped from his
lips, read and hear the terms in which some who give them-
selves out as his followers, permit themselves to speak of this
great and good man, and unblushingly draw upon their imagi-
nations in giving utterance to the most erroneous and fabulous
accounts of his opinions and actions, showing an incredible
ignorance of the maxims and truths contained in his works^
60 Address of the Presideni.
of his conduct throughout his long and honourable career, and
an iiTcvereuce for the genius, the enidition, and the unwearied
industry which enabled him to create and establish the system
of medicine by which they gain their livelihood and hope to rise
to fame and fortune. One knows not which to admire most, the
ingratitude or the presumption of such soi-disant disciples of
Ilahuciiiann. However, this mode of the young to be pre-
sumptuous and to ignore the wisdom and knowledge of their
superiors is of all time. Pliny the younger records of the
youth of his day — " Barum hoc in adolescentibus nostris, nam
quotusquisque vel aetati alterius vel auctoritate ut minor, cedit/
Statim sapiunt ; Statim sciimt omnia ; neminem verentur; imi-
tantur neminem; atque ipsi sibi exempla sunt !"
Dr. Cockbum builds a somewhfit ingenious argument, already
often put forward in Germany and France by our AUopathic
opponents, against the use of infinitesimal doses, upon the
assumption that in the course of repeated triturations the
original medicinal matter will be entirely lost in some portion
of the preparation, fix)m the impossibility of effecting a suffi-
ciently fine subdivision of its particles. It is plain, although
strange, that he has never read Dr. Samuel Brown's admirable
essay on the theory of small doses. It is equally strange, that
in the debate which followed the reading of Dr. Cockbum's
paper, one of the speakers has reiterated the interrogation —
" Why should we use the 6th dilution, when the spectrum
analysis shows the substance only as far as the 5th ? Why not
stop at the point where we know medicine to be ? " It is sur-
prising that it did not occur to the questioner, in answer to his
query, that the spectrum analysis, which only discovered
matter in the 5th dilution the other day, simply verified the
previous observation made by means of Homoeopathy, that the
vital test is far superior to any chemical one. In the essay on
the theory of small doses, above alluded to. Dr. Brown says: —
" The numerous able works asserting the utility of Homoeopa-
thic practice, on the ground of sheer experience among the sick.
Address of the President. 61
are calculated to impress their opponents with the conviction
that there is certainly enongh of practical truth in the prin-
ciple to authorise them to give it a candid trial, since so many
of their equals, in whatever is scientific and virtuous, are
ready to stand by both the principle and the practice. Let
them take the fact of the number and merit of Homoeopathic
physicians and books as their certificate of right to make ex-
periments upon their patients, especially since it will only be
doing nothing at the very worst, and, still more especially, as
they are well used to the art of prosecuting experimental inves-
tigations of a far more formidable kind, in connexion with the
custom of exhibiting sensible doses of the most potent and
untried of chemicals. Such is one view of the question ; but
still a theory of small doses is the desideratum.
The Professor of Mathematics at Prague has endeavoured to
supply this want according to his habits of thought, his ability,
and his means. Professor Doppler is not a physician, nor
yet a Homoeopathic partisan, but simply brings the light of a
certain physical distinction to bear on the question at issue,
being ready neither to oppose the prevailing school of medicine,
nor to abet the followers of Hahnemann, but, having been dis-
turbed, and probably vexed, by the noise of the imcharitable
fight around him, being willing to say whatever his own com-
mimication with science, elsewhere than in medicine, might
enable him to advance to the point The gist
of the argmnent he leads out is to the effect, that the question
of greatness, respecting material operations, is altogether relative
to the kind of operations investigated. The quantity of caloric
in the whole world, if it were expressed, and could be condensed
by some Farraday or Thilorier on a scale of the most deli-
cate of balances, would not make it kick the beam so sensibly
as the thinnest breath of air — ^if at all ; yet, that latent heat
is so magnificent in power, that certain local disturbances of its
equilibrium are productive of earthquakes and volcanoes ; and
Newton used to boast, with that quick pleasantry of illustration
C2 Afifirfss of the PrrMeni.
which was or chnractoristic of him as his sure induction, that
if he were the master of fire, he could pock tho planet in a
nutshell. Electricity, too, is said to l>o imponderable; but tho
siulrlen ivstoration of the iiit<?rrui)ted balance between such
quantities of tho subtle thiid as an* contained in opposing
clouds, theiiisclves so diniiuutive in cum]iarison with the body
of tho oailli, is the cause of thunderstorm. Nothing created is
great or little, excojjt comparatively, and in relation to its effects
and the methoil of oi>eration. Hence, there may arise on the
very threshold of the inquiry, the preliminary question, whe-
ther a medicine acts on the frame by virtue of its ponderable
quantity, or by the extent of its surface wliich is brought in
contact with the surfaces of the structures on which it re-acts ?
This query must be ultimately answered by the extensive obser-
vation of physicians seeking a reply to it ; but to the physicist
it is plain, that if the latter be the true rationale of the opera-
tion of medicines (so far as that is physical), the Homoeopathist
prescribing the deciUionths of grains may, after all, be giving
greater doses in reality than the Allopathist when he exhibits
his ounces. So reasons Doppler ; and distinguishing that phy-
sical superficies of a body which is the simi of the exposed
surfaces of its exposed particles, he shows that the triturations
practised by the Homoeopathic pharmaceutist increase the latter
surface — that is, the surface that shall be brought into reaction
with the tissues — at a very rapid rate. A cubic inch of brim-
stone broken into a million of equal pieces, a sand grain each
in size, is magnified in sensible surface from six square inches
to more than six square feet. It is calculated in this way
that, if each trituration of the Homoeopathist diminish his drug
a hundred times (an extremely moderate allowance, I aver),
the sensible surface of a single inch of sulphur, or any other
drug, shall be two square miles at the third trituration ; the
size of all Austria at the fifth ; of Asia and Africa together at
the sixth ; and of the sun, with all his planets and their satel-
lites— at the thousandth ? No, but at the ninth !
Address of the President. 63
The method of trituration is very simple. A grain of the
drug to be prepared is carefullj rubbed down in 99 grains of
soluble, insipid, and pure sugar of milk, which is extensively
made in Switzerland from the residuary whey produced in the
manufacture of cheese; a grain out of this 100 is triturated
with other 99 of the sugar of milk ; a grain of this mixture of
the second dilution is, in its turn, diflfused through 99 grains of
fresh sugar, so as to produce the third dilution ; and so on to
the thirtieth, or beyond it.
In connexion with the trituration of insoluble solids, it has
been objected, that if, for example, a million of separate parti-
cles be contained in a grain of the third trituration, and that
trituration be then diffused through 100 drops of pure water,
each drop wiU contain 10,000 particles; that one of these
drops, diffused in 100 of pure water, will give 100 particles
in each drop; that the next dilution will yield only one
particle for each drop ; that consequently, in the next grain
there must be 999 drops of water without a single particle of
the original metal, or other insoluble body; and that, in fine,
the higher dilutions of the Homoeopathic practitioner are
hereby for ever demonstrated to be null and void, at least in
the case of insoluble substances. This looks very shrewd,
and even heis an air of the recondite about it. But who
assured the sagacious amateur that the ^ects of trituration, in
the way of diffusion, though indefinitely inferior to those of
true solution, are to be calculated by petty millions of particles ?
Besides, there is every probability that the diffusion through
the milk-sugar is, at a certain point, consummated to the degree
of solution itself by chemical reaction throughout the mass.
Molten iron solidified has no action whatever on dry air, and
even when subdivided by filing, does not oxidate itself, without
the disponent help of water and carbonic acid ; but let it be
reduced from the state of hydrated peroxide by hydrogen, at a
temperature not far above the boiling point of water, and no
sooner is it shaken out of the apparatus in which the opera-.
04 A tf dress of the President.
tioii has hoon conducted, than it bursts into combustion. All
h()(li«s can unite chemically with each other, if the proper cir-
oumstaiicps he alForded them; and all solid bodies must sufiTer
mutual reaction, if j»ivscnti*d to one another in fine enough
(livisinn. This is exactly the* case in the instance under notice.
The insoluble hocly — say the metal — unites chemically with
the su^ar, becomes everywhere diffused in a degree of division
far rcMnoved beyond computation by numbers, and the sac-
charine; com])ound, probably still insoluble in the true sense of
tli(; tc^ni, rapidly passes through the closest filter, and remains
sus])en(led invisibly among the particles of the solution. This
is surely tlie reverse of incredible to the chemical analyst.
In a word, let such dilettanti as found objections on their own
limitation of mechanical subdivision, and on their own in-
ade([uate conception of the nature of particles, remember the
rigorous calculation of an eminent astronomer of their own day,
that Encke's comet, vast and wide-spreading as it sweeps
through the firmament, is composed of an air so attenuated,
that if, by some transcending force, it were compressed to the
density of our atmosphere, it might be folded in a walnut,
and they will never attempt the gratuitous task again."
The next paper is a valuable one, although rather desultory,
by Dr. Hilbers, of Brighton, entitled " Ohservations on some
Qitestiom of Medical Ethics, with Special Reference to so-
called Homoeopathic Practitioners^ It is written in a liberal
spirit, and contains much practical matter, interspersed with
some excellent advice to younger practitioners, which they will
do well to follow. With respect to the employment of auxiliaries,
so frankly dealt with by Dr. Hilbers, which was the subject of
Mr. Harmer Smith's paper, I am decidedly of opinion that it is
impossible to attempt to lay down rules for their use. Their em-
ployment must ever be exceptional. It is a matter to be left to
the conscience of the practitioner, and to his sense of duty to
his patient — dependent on his consciousness of his own want of
knowledge of the powers of Homoeopathic remedies, and his
Address of the President. 66
inexperience how to select them in exceptional cases, not only
in the cure, but in the palliation of disease, when the amount
of pain or suffering is such as to cause the patient, his friends
and physician, to desire more immediate relief than the pro-
gress of treatment strictly curative [which aims more at ulti-
mate results than at immediate effects] will admit of— ^iependent
sometimes upon the previous habits superinduced in the organ-
ism by the past Allopathic treatment, which in some cases it is
more prudent to attempt to antidote, and in others safer
gradually to wean the patient from, than suddenly to stop-
dependent sometimes upon the state of mind and prejudices of
the patient and Mends, with respect to the action and virtue of
Homoeopathic medicines, which have not only the original
disease to combat, but often an endless complication of symp-
toms produced by a long persistence in the use of drugs in
large doses— dependent sometimes upon the practitioner's Allo-
pathic experience of by-gone days, of the palliative virtue of
means which will give temporary relief to pain or suffering, and
cause but a short and slight interruption to the curative treat-
ment sought for by the administration of Homoeopathic reme-
dies. It would be utterly useless to seek to establish a prin-
ciple to guide us in such exceptional cases.
My experience fully bears out the opinions expressed by
Dr. Hilbers, that the tendency to the employment of auxilia-
ries exists more in the practice of those practitioners who
give large doses of medicines, often in the more crude and
material form, than in those who habitually prescribe infini-
tesimal doses. I have perhaps better and more frequent
opportunities than most other Homoeopathic physicians of
forming a correct judgment upon this point. From the fact
of my name having been longest before the public as con-
nected with Homoeopathy, and from my age^ and position as
consulting physician, many cases are brought to me which have
previously been under other Homoeopathic practitioners and in
the history of the cases and detail of the past treatment given
VOL. m. 5
6 6 Address of the President.
to mo, I have almost invariably found that the resoit to auxi-
liaries has been much more frequent in the treatment pursued
by those practitioners who are in the habit of prescribing large
doses. I have also almost invariably observed that as each
Iloiuoeopathic practitioner has gained more experience of the
powers of homoeopathic medicines, he has abandoned the larger
doses, and approached nearer to the practice of Hahnemann and
his earlier disciples in prescribing infinitesimal doses ; and I can
confidently affirm, from all I have observed, that increased suc-
cess in the treatment of their cases has attended upon the changa
With respect to the point so creditably and liberally treated
by Dr. Hilbers, of what ought to be our demeanour and con-
duct to our medical opponents of the prevailing school, I have
so often expressed my sentiments in former addresses delivered
from the chair, and in our debates, that it is unnecessary for
me to do more than reiterate my advice that we should never
imitate them in their iUiberality, dogmatism, and uncharitable-
ness. It is gratifying to reflect that some of the most distin-
guished amongst our Allopathic fraternity are above the petty
considerations, the pusillanimity, and the bigotry, that have
influenced many of their own body, to their own loss much
more than to ours. But in nothing do I agree with Dr. Hilbers
more than in his opinion with respect to what should be the con-
duct of Homoeopathic practitioners towards one another — an
opinion in complete accordance with the advice I have over and
over again endeavoured to impress from the chair and in our dis-
cussions— ^that we should avoid the reprehensible habit in which,
I am grieved to say, some of our body indulge, much to their
own loss and discredit, of condemning and speaking slightingly
to their patients and to the public of the practice and the doses
prescribed by others, because they differ from their own.
An -eq^ually suicidal course, and one still more strange, is the
pretension of some of the so-called Homoeopathic practitioners to
speak disparagingly of the action of globules — ^nay, to deny
that they have any action at all ; they at the same time affect
Address of the President 67
to hold in contempt those practitioners who prescribe them» —
whilst, with laughable self-sufficiency, they claim for themselves
a superiority of intellect in having discarded them, or of never
using anything but triturations, tinctures, and pilules. Now, it
is indisputable that the introduction of Homoeopathy over the
Continent, into England and into America, was mainly if not
solely eilected by the employment of globules impregnated
with medicine in the treatment of disease homoeopathically.
I can answer for my own practice, that for once that I em-
ploy or have employed tinctures or triturations, I have at least
prescribed globules sixty times, and my success, I believe, has
not been behind that of my neighbours, and for many years I
stood quite alone in England the only Homoeopathic physician.
Drs. Eomani, Tagliabo, Belluomini, Dunsford, and others, who
followed some years after me, almost invariably prescribed medi-
cine in the form of globules. Dr. Constantino Hering, of Phila-
delphia, who was among the first to' carry Homoeopathy from
Grermany to America, was, and I believe is, a strict Hahne-
mannist with respect to his doses. Most of the distinguished
Homoeopathic physicians known to me in France, Italy, and
other parts of the Continent, are constantly in the habit of pre-
scribing globules. And among my friends and colleagues in Great
Britain I have no hesitation in saying it is my firm and consci-
entious conviction that those in the most extensive and success-
ful practice And in the highest repute, prescribe globules. Let me
not be misunderstood as wishing to convey that either I or they
confine our prescriptions to medicines in the shape of globules,
or have tied ourselves up never to employ any other prepara-
tions ; on the contrary, we are frequently in the habit of pre-
scribing tinctures, triturations, and pilules, as well as globules,
in every variety of attenuation from the lowest to the highest,
according to the more or less susceptibility of our patients to
the action of the medicines — according to the phases and
variations that occur during the treatment of our cases, and
according to the promptings of our judgment and experience.
5*
68 A ddress of the President ^
I must here also guard myself &om being thought to desize to
place trammels on the judgment and experience of others in pre-
fening to prescribe laigo doses only, if they and their patients
think such practice best It is against their illiberal and un*
professional conduct only, in running down their colleagues
who believe in the efficacy of infinitesimal doses, and conse-
quently prescribe them, that I am contending here. Kow,
what are globules ? Merely a convenient vehicle or method
recommended by Hahnemann for prescribing fractions of a
drop when the whole is not considered necessary to produce
the desired efiTect, or when it is desired not to give the whole
drop at once, but to subdivide it into more fractions or smaller
doses than it would be convenient to do by diluting it in
water. It is notorious that some of these practitioners who
proclaim their disbelief in globules, prescribe sometimes
tinctures in the 3rd, 4th, 5th, and 6th, and even higher
attenuations ; consequently they avow their belief in the mil-
lionth and billionth of a drop of the material ding they pre-
scribe. Well, two or three globules impregnated with the
1st, 2nd, or 3rd attenuation contains much more of the
crude or material drug than any drop or number of drops of
the 4th, 5th, 6th, or any higher attenuation; so that upon
their own showing, and upon the plea advanced by them
of what causes the efiQcacy of their fietvourite doses^ theii
reason for expressing disbelief in the efiQcaoy of medicines
given in globules as the vehicle, is purely and simply an
absurdity.
Another strange idea which has taken hold of some of the
so-called Homoeopathic practitioners is, that there is little or no
efficacy in medicines prepared by the centesimal scale adopted and
recommended by Hahnemann, and which has been in general
use sincd the commencement of Homoeopathy, they preferring
the decimal preparations. I remember having a consultation
with one of these gentlemen^ who on my suggesting a medicine
which he had not prescribed in the case, readily consented.
Unpublished Letters of Hahnemann, 69
but demurred somewhat on my stating the attenuation in
which I considered it would be most efficacious, and he hoped I
would not object to his giving a decimal preparation instead,
as he had for some time ceased to employ any other. On
inquiring what dilution he proposed, he named the 6th. I
asked why he preferred that to the one I had suggested, and
anything more startling and illogical than his reply cannot well
be imagined ; for, to my astonishment, he said, because it is
much stronger and more active. Now, as I had recommended
the 3rd attenuation, which is exactly identical in strength in the
centesimal scale with the 6th attenuation in the decimal,
you will understand my surprise. I endeavoured to point this
out to him, but without success. Such powers of calculation
are enough to raise the ghost of Cocker !
I have now, I believe, touched upon the different matters
which have engaged the attention of the Society during the
past session, and have candidly expressed the opinions which
my forced absence from the Society's meetings prevented my
doing, whilst summing up, in the course of your debates.
UNPUBLISHED LETTEES OF HAHNEMANN.
To Dr. Stapp.
Koethen, May 5th, 1831.
Deab Friend and Colleague,
I must get the horrid chancre dissertation out of the
house, and so I send it you along with this, as I should have
done long ago.
I also send you a very nice guide for patients in search of
assistance, by the Baron Yon Bonninghausen, in Munster. I
beg you will send a copy to Dr. Schweikert, for publication in
lis journal, as I do not know whether he is in Grimma. "WIl^
70 UnpubliMhid Letters of Hahn§manjk.
do yoa say of the article in the 92xid number of Yo88*s
Journal, by Pn^fossor Schulze. of Berlin, upon the Homceobiotio
lleiliciiio of ruracelsm ? According to him I haye taken my
systom out of this man's writings (umntelligible gibberish !),
but have not rightly understood it. and have confused it in the
taking. Paraoelsrs understood it better ! From this point no
one has yet attacked Homoeopathy — it was still to da Do you
know anything of a Homceopathic physician. Dr. Mayerhofeir>
of r>remen, who has an immense practice, and is Teiy highly
esteemed by his patients ? I heard of him &om a friend who
had liveil for some time in Bremen.
After you have thoughtfully perused the work upon the
Katuml Birth, I beg you will return it as soon as yon can, for
the theologians hero are most anxious to see it.
I am prevented writing more just now, and so I mnst con-
clude with my greeting to your dear household.
Saiiuxl Hahneicann.
To Dr. Stapf.
Koethen, August 5ih, 1831.
Dear Friend and Colleague,
I send you along with this a globule ot the 30th of Carb.
An., and I hope it will prove nsefuL I trust that she walks in
strict obedience to my warning letter. I am greatly pleased to
hear of the improvement of my beloved Hermann. Next to
Capsicum, Carb. Anim. is of the greatest service in this epidemic
of fever.
I have had Straube, that excellent man and accomplished
and modest artist, with me frequently, and I have come to like
him dearly, as well for his own sake as for his convictions in
favour of our science.
Preu, in Numbei^, I like mnch, and am obliged to you fop
lotting mo see his letter. So long as the Allopaths give ns
false pictures of the cholera, i^resenting it as a combination of
Unpublished LsUers of Hahnematm. 71
vomiting and diarrhoea^ it was natural that we unfortunate
Homoeopaths, at a distance and unable to obsenre for onrselveSy
should be misled unto the belief of the specific value of
Veratrum and Arsenicum in the disease; but the true discrip-
tion given by a Homoeopathist shows that the essential cha-
racter of the disease is wholly different ; that it is an affection
of the whole system, which only at its termination assumes the
form of convulsions and paralysis, accompanied by wateiy
vomiting and purging only in certain cases; in most cases
nothing of this takes place-— only rapid death. Here, neither
Veratrum nor Arsenicum can be expected to do good. Schreter
writes from Lemberg, that he effected something, but not much,
by means of Veratrum, and when that did no good Camphor
was the remedy (he had just got my article upon Camphor).
I was told within the last two days by an eye-witness that
when cholera ravaged Odessa, some months ago, the treatment
pursued there was rubbing the patient over with Camphor,
which rescued many of them; he himself had treated nine
patients with Camphor, and all of them recovered. What
further testimony do we require ?
The medical authorities in Berlin and Vienna have refused
to allow my article upon the utUity of Camphor to be pub-
lished in the JoumaL In Berlin it is to be printed by a book-
seller, with Stiiler's introduction. I wish you would allow the
explanations in reference to the dose I have written about this
introduction of Stiiler's, who makes some malicious observations
about the size of the dose, to be read at the meeting of the
10th of August.
I have also been asked by a Leipsig bookseller to allow binn
to publish the articla It wiU shortly appear, printed by
Gluck. He is to sell it for nine gt. gr. I have prepared it in
an entirely popular form, omitting all scientific details.
My likeness on steel is not yet ready, else I should gladly
send it you. I am much pleased at yours.
Bjominel ha^ managed that article capitally. I trust. that
*'.*.'ii-? vll *i*-tr '^ 2X1* ^ -P2SS ai lieir i»g.L -^
•- V . -_ vr !.:.;_ LA"* "LZiti Liii '.ra=fi "Su- ^/'Jf
;. .r: -^ .■. v ._iz ^tS^M. ' JL. ^ «i^ iJC
;^nnals ai tbe ^nspital.
r;o;;Mj;i>fNG lkcture on laiEOiAnsM.— ox the
liO.h A NO TMK ALTKKNATIOX OF THE MEDICINE.
I5y \)\i. Kr;s.SELL.
(li.MM MKf/, r pr,f.l,poTK!(l Ujo coDsidoratioii of the methods
n( ii<lfiiihiftl,frin|^ HotiinopHiliic medicines, that I might treat
Mil iiihjirl. of I.Ik' <Ioh(! with Horiictliiiig like the fuLiess its
iiii|iMihitM n (l('iiinii(l('(|. And now that I come to fulfil my
|il''li" , iiiid Id I'lilcr ii|M)n (I ({iH'.st.ion that has caused so much
iMid mil h \Miiiii diMniMMJon, I frcl tho greatest hesitation and
it.liii liiiM i> III iiiiliMiii)r ii|M»n Mm t'liHk. It is quite out of my
|iM'M I In jilvp nvnii Mm lirirfpHt. (uiMinc^ of controversies both
MiHiiii mid wiMiniil. mil' <i\vu l)od\\ which this question has
(III Hid , tMiiliiivniMJnrt iMiiidiK^hul with luuch ability on both
»«iili>< lull iimI> Hlwiiyri wlMk |Mirloot nuukmr and equanimity on
I'iMiii iildti
r.i.i.iiii)! Hiitiii Ity liir (ho phmout at toasts lot us attempt
\s\\\\\ III iinihiiMlHud whu( iho iUOWuIUoh tux> ^vhich have pre-
Lecture hy Dr. Russell, 73
vented the some unanimity among the adherents of Hahnemann
in reference to the proper dose of Homoeopathic medicines as
happily prevails in regard to the fundamental dogma oh which
his system is erected, and fix)m which the minor proposition
that a substance chosen according to the principle expressed
in the maxim, " SimUtcs similibus curarUur,'' should, to effect
a cure, be given in a quantity infinitely less than practitioners
of medicine had been in the habit of employing up to his
tima To use his own words, as he expresses himself in the
278th paragraph of the Organon — ^"Here the question arises,
what is the most suitable degree of minuteness for affording
certain and gentle relief? — ^how small, in other words, must be
the dose of each individual medicine (selected according to the
Homoeopathic principle for a case of disease) in order that it
shall best effect a cure? . . . Pure experiments, careful
observation, and accurate experience can alone determine this ;
and it would be absurd to adduce the large doses of unsuitable
(Allopathic) medicines of the old system, which do not touch
the diseased part of the organism homoeopathically, but act
only on those parts unaffected by disease, in opposition to what
pure experience pronounces respecting the requisite minuteness
of the doses for effecting Homoeopathic cures." The question
is here fairly stated to be one which can be correctly
answered only by eocperiment, observation^ and experience.
Let us consider how it happens that we have up to this time
obtained nothing but confused, evasive, and contradictory replies
to the interrogations put to this collective oracle.
At the outset of the inquiry we perceive a fundamental
distinction between the processes of investigating the question
of the proper dose of an Allopathic and a Homoeopathic
medicine. In Allopathic practice the design, as Hahnemann
states, is, by acting on a healthy organ, to induce a salutary
change on the part of the body affected with diseasa For
example, in a case of rheumatic inflammation oi the knees,
our Allc^athic practitioner might give a purgative, a AtaaMvi
74 Lecture hy Dr. EusaelL
or a sudorific, and opiate. If he is asked how he knows what
quantity of any of these drugs ought to be administered, his
answer is ready, — " that will depend upon the amount of effect
required." The effects of the substances he employs have been
ascertained with greater or less precision by scientific processes.
It is known to a nicety what quantity of castor oil will operate
as a purgative, and what quantity of opium is required to pro-
duce sleep. Making a certain allowance for the disturbing
action of morbid causes, he selects his dose of medicines
according to the table put into his hands by the toxicologist
For an Allopathic practitioner to give the millionth of a drop
of castor oil to induce purgation, or the billionth of a grain of
opium to procure sleep would be a manifest absurdity. His
aim is definite, and the means to attain it equally so. The
question is not now whether or not purgation be desirable;
but supposing it to be so, how is it to be obtained ? He can
graduate his dose so as to produce to considerable nicety the
amount of the particular action he wishes, because he is acting
upon the sound part of the frame, according to physiological
principles established on the secure basis of repeated experi-
ment. But the position of the Homoeopathic practitioner is
wholly dijfTerent. The effects he strives to obtain are not
positive, but negative. For what is a ciire but the n^ation of
disease? The more perfect the method, the more entirely
absent is all positive effect. This, then, is his problem —
" Given thirty different doses, all of which have the power of
acting curatively upon a diseased organ, while none of them
produce any appreciable effect upon the sound parts of the
body — ^how is he to ascertain which one out of the thirty exerts
a curative power in the strongest degree V* The simplest^ and,
indeed, the only way to solve this problem is, by a seriies of
trials of the same medicine in different dilutions administered
in similar circumstances. But at the very threshold of the
investigation we encounter the almost insurmountable obstacle
of contriving experiments which shall meet the requirements of
Lecture by Dr. Rtusell. 75
the casa The difficulties that beset the whole class of such
inquiries are thus expressed by Mr. J. Stuart Mill, in his great
work upon Logic — " Let the subject of investigation be the
conditions of health and disease in the human body-— or, for
greater simplicity, the conditions of recovery from a given dis-
ease ; and in order to limit the question still more, let it be
confined in the first instance to this one inquiry, Is, or is not,
a particular drug — mercury, for example — ^a remedy for that
disease ? . . . When we devise an experiment to ascer-
tain the effects of a given agent, there are certain precautions
which we never, if we can help it, omit. In the first place, we
introduce the agent into the midst of a set of circumstances
which we have exactly ascertained. It need hardly be re-
marked how far this condition is from being realized in any
case connected with the phenomena of life ; how fiEur we are
from knowing what are all the circumstances which pre-exist
in any instance in which mercury is administered to a living
being. This difficulty, however, though insuperable in most
cases, may not be so in all; there are sometimes (though I
should think never in physiology) concurrences of many causes
in which we yet know accurately what the causes are. But
when we have got clear of this obstacle, we encounter another
stUl more serious. In other cases, when we intend to try an
experiment, we do not reckon it enough that there be no cir-
cumstances in the case the presence of which is unknown to
us ; we require also that none of the circumstances which we
do know shall have effects susceptible of being confounded
with those of the agent whose properties we wish to study.
We take the utmost pains to exclude all canises capable of com-
position with the given cause ; or, if forced to let in any such
causes, we take care to make them such that we can compute
and allow for their influence, so that the effect of the given
cause may, after the subduction of those other effects, be
apparent as a residual phenomenon. These precautions are
inapplicable to such cases as we are now considering. . . .
7 6 Lecture hy Dr. Russell.
Anything:; like a scientific use of the method of experiment in
those coinplicatod cases is therefore out of the question. We
can, in the most favourable cases, only discover by a succession
of trials, tliat a certain cause is ver}" often followed by a certain
efreft/' — Mill's "Logic," vol. i. p. 529. I have quoted this
utt(»rance of inexorable Logic, not that I believe it to be at
all impossible to establish by a sufficient number of instances.
that the administration of a certain remedy is followed, by
virtue of the law of causation, by the cure of certain forms of
morbid action, but to put us on our guard in dealing with the
question before us, by exhibiting the category to which the
problem belongs. It is one of mixed causes. Without under-
valuing the power of a medicine to effect a cure, yet it is
obvious that this curative action is only one of several causes
which bring about the recovery of a patient. The duty of a
physician is not to make experiments upon the sick entrusted
to his care, in order to determine with scientific precision the
exact value of a given remedy ; it is, to employ all the means
in his power to accomplish the object of his vocation. He
must, to the utmost of his ability, remove from his patient all
noxious agencies, and accumulate all salubrious influences about
him. He must improve his diet, his habits of exercise, or of
rest ; he must convey hope and confidence if possible into his
mind ; and in short, he must exhaust all his ingenuity for the
welfare of the sufferer, just as if he had no medicine to give.
Into this multitude of healing forces he drops his globula
Let it not be supposed that I regard the globule so adminis-
tered as a trifling addition ; on the contrary, I am firmly per-
suaded that, in most cases, it exerts greater powers in bringing
about the happy result than aU the other influences put toge-
ther. Nevertheless, to overlook the other co-operating causes
of the effect would be as great an error on our part as is the
mistake of our opponents in ascribing our cures to these causes
alone. Let us now fairly confront the problem. The question
-" Here are thirty different doses of the same substance, —
Leettt/re by Dr. Riissell. 77
all the thirty possess the power of curing, — ^to ascertain which
of the thirty possess their power in the highest d^pree?" The
only conceivable method of setting about the investigation is
to institute a series of experiments. What are the conditions
required to give such experiments any scientific value ? It is
obvious that the physician must begin by selecting thirty cases
of the same description in every particular; that the cases
.iQiust be of some complaint which does not tend to a speedy
spontaneous recovery ; that for each of these cases, the medi-
cine experimented on is equally well suited; that all the
persons are placed in exactly similar circumstances as regards
the other sanative influences ; that they are all equally sensitive,
naturally, to the action of the particular remedy which is being
tried ; that the experiment shall be made by the same physician,
at the same season of the year, surrounded by the same epidemic
and atmospheric influences ; and that it shall last for several
weeks, or even months. But one series of such experiments
could not by any possibility afford any trustworthy results. It
would require many such series. Now I ask, — ^has this ever
been attempted, or is it likely that it ever will be ? Common
sense tells us that the difficulties of performing such experi-
ments are absolutely insurmoimtable. But till they are over-
come> I do not see how we can even expect to arrive at a law
regarding the dose. This can be attained by a process of induc-
tion alone ; and the only facts available for such induction must
be obtained by some such process of experimentation as I have
sketched. All d priori attempts to frame such a law have
utterly failed.
The practice of giving medicine in 'extremely minute doses,
in cases treated homceopathically, rests partly upon reason,
partly upon experiment. The rationalty of the practice was
explained sixty years ago by Hahnemann, and with more force
and clearness, in my opinion, than by any subsequent writer
on the subject In a letter addressed to Hufeland, and pub-
lished in his celebrated Journal in the year 1801, Hahnemann
7 8 Lecture by Dr. Ruuell.
writes: — "You ask me what eflPect can l-100,000ih part of
a grain of Belladonna have ? The word can I dialike ; it ia
apt to lead to misconceptions. Our compendiuxns have alxeady
decided what medicines can do when given in certain doses;
and they have told us exactly what we are to use ; they have
determined these matters with such precision that we might
look on these volumes as our sacred books, if medical dogmas
were to be believed as articles of faith. But, thank Heaven,
this is not the case ; it is well known that our works on
Materia Medica rest on anjrthing but pure experience — ^that
they are, in fact, the inanities of our great-grandfathers re-
peated without examination by their great-grandsons. Let us
not, then, inquire of these compendiums, but let us ask nature
what effect has 1-1 00,0 00th of a grain of Belladonna? But
even in this shape the question is too wide ; it must be put in
a more definite form for reply, by the addition of the qualifica-
tions, ubi, quo modo, quando, quibus auxiliis.
" A hard dry pill of extract of Belladonna produces on a
P robust, perfectly healthy peasant or labourer usually no effeck
But from this it by no means follows that a grain of this ex-
U tract would be a proper or too small a dose for such a man if
: ; he were ill, or if the grain were dissolved. The most healthy
)A and robust labourer will be affected with very violent and even
{;J dangerous symptoms from one grain of the extract of Bella-
i; donna, if this grain be dissolved in, say, two pounds of water,
and if he take it in spoonsful within six or eight houis.
These two pounds will contain about 100,000 drops. Now, if
one of these drops be mixed with other 2,000 drops of water,
and twenty drops of this mixture be given every two honis,
they will produce effects not much less violent if the man to
whom they are administered be HI. This dose contains about
one-millionth part of a grain. A few teaspoonfols of this
., mixture will, I aGBrm, bring to the brink of the grave a person
seriously ill of a disease to which the action of Belladonna
II bears a close resemblance.
Lectu/re ly Dr. Russell. 79
'"The liard pill of some grains of Belladoxma finds few points
of contact in the healthy body ; it glides almost nndissolved
through the intestinal canal, protected by its layer of mucus.
But it is very different with the same substance when dissolved.
Let the solution be as weak as it may, on being received into
the stomach it acts on a much larger surface and excites more
severe symptoms than the pill which contains a million times
the amount of medicine is capable of doing."
In this letter, written more than sixty years ago, we have
the most explicit statement of the conditions which combine
to make the administration of medicines in minute doses ob-
viously rational These conditions are twofold; the first is
that the substance shall be prepared in such a way as to enable
it to come in contact with a larger surface of a part of the
body highly endowed with nervous sensitiveness. This is a
physiological reason. A healthy man would be poisoned by a
dose of Belladonna or Opium, if given in solution, which
would be comparatively innocuous if given in the form of a
pilL The second condition is pathological, viz., that an organ
in a morbid state is morbidly alive to morbific agencies — as
the inflamed eye to intense light, inflamed joints to rough
movement, &c.
K Hahnemann had stopped at this point, he might have
effected what I may call a bloodless revolution in medicine.
But he did not stop hera A few years after writing the
passage just quoted, he uttered the astonishing proposition that
a globule of the decillionth of many substances known to be
wholly inert in massive doses, had the property of exerting
an enormous power upon the living organisms when it
was aflSicted with symptoms of disease similar to those these
substances produced when they were prepared and administered
in a certain way. It is obvious that in making such an
affirmation, Hahnemann left behind all A priori probabilities of
its truth. The reasoning he employed to render credible that a
millionth of a grain of Belladonna was more potent than the
80 I^durt hy Dr. RusmU.
whole grain, inasmuch aa the former acted on a larger anrbce^
is inapplicable in regard to a globule of the 30th dilution of
calcanM for example, placed upon the tongua Up to a cer-
tain point, analogy is all in favour of minute doses; beyond
that j)oint I confess it seems to me that we can derive little, if
any, support from analogy.
On what then do we rely if we entertain the belief that a
globule of the decillionth of a grain of Calcarea is a powerful
medif.ine ? Simply and exclusively on testimony and our own
observations.
Let us consider the evidence in favour of this astonishing
proposition. The first witness is Hahnemann himseli Is his
testimony worthy of credit in this matter ? We require of a
trustwoi-thy witness that he shall be competent in knowledge
of the subject ; and that he shall be veracious and accurate in
his statements. Of Hedinemann's acquaintance with the sub-
ject, and capacity of observing facts in regard to the action of
the high dilutions of medicine, there is no need to speak. He
had ample opportunities and undeniable ability for the task.
I5ut what of his accuracy and trustworthiness as a recounter
of observations ? If Hahnemann be not accurate and trust-
wortliy as a critical observer and faithful narrator of his own
observations and those of others, then the whole feibric of
Ilomoiopathy rests on an unsound foundation; for be it re-
membered that nine-tenths at least, if not nineteen-twentieths,
of the observations upon the actions of medicines which are in
daily use by Homoeopathists are derived fix>m Hahnemann's
Materia Medica : and observe what an tmenviable position
those men occupy who are in the daily habit of employing the
medicines introduced into practice by Hahnemann, prescribing
Belladoima, Pulsatilla, Bryonia, &c., not because they them-
flclvos discovered the virtues of these drugs, but because
Halmomann has done so, and left directions for their proper
use, and who, although tacitly acknowledging his trustworthi-
ness, yet tell us that they have no faith in globules of the high
Lecture by Dr, Rtissell. 8 1
dilutions I I could quite understand their position if they
were to say, We have tried both the low dilutions and the high
dilutions, and we find the latter of no avaiL But I do not
find that those who reject Hahnemann's statements in reference
to the action of the high dilutions have submitted them to a
careful course of experimentation. On the contrary, it seems
to me that they act exactly as they blame the opponents of
the homoeopathic system for acting — ^that is, they deny that
these doses can act, because it is against their notions of what
is possible. But who shall say what is possible and what is
impossible ? Facts alone, facts carefully observed and accu-
rately reported by witnesses beyond suspicion, can decide such
a question as this. Hahnemann, as we know, with nothing to
gain and all to lose by a false step, firmly maintained his
course, and in cases of the severest illnesses of those most
dear to him, trusted in his globules of the 30th dilution. Since
his time a multitude of other observers have borne testimony
to the efficacy of these extremely minute doses. If we were to
poU all the homoeopathic practitioners over the globe, and put
the question to them, " Do you believe that a dose of Calcarea
of the 30th dilutionhas any power ? " I am convinced that there
would be an overwhelming majorrt- in favour of the affirma-
tive.
All who have earnestly devoted themselves to the study of
the Materia Medica, and to an experimental verification of
Hahnemann's original experiments upon himself with the
medicines it contains, have borne testimony to the wonderful
fidelity and accuracy of all the statements that rest upon his
own personal observations. Are we then to throw all these ob-
servations to the winds, and to begin a reconstruction of this
great edifice, which looks rather like the growth of ages than
the effort of one man? Those who propose that we shall,
hare formed a very faint idea of the difficulties that beset a
abourer in the path of experiment with medicinal substances ;
in Iftct, nobody who practises Homoeopathy can serio\x%V
VOL. in. ?»
H2 Lecture hy Dr. Russdl,
liiako >n wilil a ]>roi>osal, for he stultifies his own piactice on
the vi-ry outset. No; logically there is no alternative: either
wf iim-t jicecpt the statement of Hahnemann and his followers,
that ;.'1m1iu1(.'s of the decillionth of a grain of such substances as
(.'ill' ar»*;i, Carln), Silic«»a, have a most powerful action on the
di>or<l-iv.l frame of man, or we must reject Hahnemann's
Mat<']i:i Medica, out of which all the manuals of practice are
dcri\ <m1. If we are not prepared for the latter altematiYe, what
\m:()\wr< of the lamentation we so often hear about these high
dilutions ? If Hahnemann be correct in his statements, then
he iiifide undoubtedly as great a discovery when he ascertained
that thf're was me<liciual power in the decillionth of a grain of
lime or charcoal as was ever made in this region of physics.
Shall we say this discovery is of no importance — a thing rather
to be ashamed of because it exposes us, who avow a belief in
it, to the ridicule of those who despise Hahnemann, his doc-
trines, and his disciples ? Were we to do so, we should deserve
the contempt of his opponents, whom we ignobly tried to
propitiate by denying our master, to avoid the scorn of the
medical world.
If on the one hand it is impossible to ascertain by the
strictly Baconian method of scientific induction the relative
value of dift'erent doses of the same medicine, and on the other
hand there is ample evidence for all the various doses ranging
from the pure tincture up to the decillionth of a drop pos-
sessing power, more or less, to cure diseases, what is the
I)ractical conclusion to which we are forced to arrive ? It is
this. The dose is not to be determined by any geneial law ;
each individual, each form of disease, each variety of the innu-
merable conditions, the sum total of which compose a human
life, has its own appropriate dose. The dose proper for this man
to-day will bo improper for him to-morrow; the one best suited
for this woman is not the best for that child ; but all men are
not to have a different dose from all women and all children.
Tlui (luostlon of the proper dose is like that of the most suit-
Lecture by Dr, RusselL 83
able food. The only answer we can give is, that that is best
which agrees best with the individual who uses it. In the
same way we say that dose is best which does its work most
perfectly. But if we are asked how shall we determine before-
hand what particular dose to select, our answer is, " It is im-
possible to give any general rule — ^it depends upon the indi-
vidual sensitiveness of the patient ; and to be able to form an
accurate estimate of this, requires the special medical faculty,
the possession of which, in a greater or less proportion, is the
grand reason of the difference in the success of one practitioner
as compared to another. The same kind of rapid perception,
almost intuition, which enables any physician to form at once
an accurate judgment of the nature of a case, will enable such
a man also to form a correct opinion as to the amount of sen-
sitiveness, and consequently the most appropriate dose. In
short, it belongs to the unteachable part of the art of medicine,
not to the teachable sciences which go to form that art. The
great practical lesson to be leamt from all that has been
written on the subject I believe to be this : " That man will
effect most cures, who, besides being duly instructed in the
action of the medicines, and possessing in greatest measure the
other qualifications for success, is least bound by any rules in
regard to the doses he employs — ^who ranges most freely from
the lowest to the highest, and from the highest to the lowest,
and is neither deterred from giving a globule of the 30th by
fear of the incredulous, or of giving a drop of a pure tincture
out of dread of the purist, and who uses his liberty without
infringing on that of others. That Hahnemann should have
desired to promulgate an act of uniformity in our posology is
natural^ seeing he was expected to do so as the head of the
largest and most influential school that has arisen since the
breaking up of the Galenic empire of medicine ; nor do I
find it strange that in his practice, Hahnemann, who, as a
flttecesfifol practitioner, was probably never equalled, should by
tti* few hints he drops in regard to the doses he em^\xyj^.
84 Lecture by Dr. Russell.
show that he was iu the habit of employing all doses, from
drops of the pure tincture to portions of a single globule of the
30th dilution.
It was natural that Ilahnemann, as the founder of a school,
should desire to introduce a certain degree of uniformity into
the practice of the system he inaugurated, for the obvious
reason which he liimself gives, that if all used the same dose
we should be better able to form a correct opinion as to the
treatment of any case, and be more secure of obtaining the
same results in a similar circumstance, than if there were a
great latitude in the amount of medicine employed; and also,
be it remembered, he fixed upon the 30th dilution to put a
check to what he regarded as the extravagancies of some of his
disciples, who soared away into the hundredth and even
thousandth dilution, and in their devotion to these ghostly
sublimities were in danger of passing into a state of such mys-
tification as to forget that the dose was, after all, a matter of
only secondary importance.
While Hahnemann claimed for the higher dilutions their
rightful recognition on the ground of their proved usefulness,
it was hardly possible for him to avoid framing some hy-
pothesis to account for the extraordinary development of
powers which had never been before revealed. The explana-
tion he advanced of these surprising powers was, that they
were evoked or engendered by processes of trituration and suc-
cession, and he termed the result dynamization. We are not
in the habit of scof&ng at Newton's discovery of the analysis of
the sun*s light by the prism, because he appended to it an
hypothesis as to the essential nature of light which is generally
disallowed ; and it seems to me to argue the opposite of a philo-
sophical character, for anyone who believes in the discoveries
of Hahnemann to attempt to hold up his hypothesis to ridicule.
If we accept his facts, his explanation is at least as good as
any that has hitherto been proposed. How does it happen, he
asks, that although the water of this district is highly cal-
Lecture by Dr. Riusell. 85
careous, it does not cure diseases for which that substance is
suitable, and which are cured by Calcarea dynamized by
trituration ? Here is a question which is yet tmanswered ; and
surely it is more unphilosophical to reject a fact because its
discoverer attached an hypothesis to it, than to frame an ex-
planation in accordance with the general theories of the time
in which the discoverer lived, which Hahnemann did. That
there are latent " spiritual " powers in matter was a prevailing
opinion long before the time of Hahnemann. It is thus ex-
pressed by Lord Bacon, " Let this be laid for a foimdation,
which is most sure, that there is in every tangible body a spirit
or body pneumatical, enclosed and covered with the tangible
parts." — Sylva Sylvarum, 696.
For my own part, I am disposed neither to admit nor to deny
the sufficiency of Hahnemann's hypothesis. It is perhaps as
good as any other, and merits careful consideration at our hands.
Still it is only an hypothesis, and does not touch the validity of
the evidence in favour of his great discoveries — 1st, that the
trae method of curing diseases is to select a remedy which pro-
duces in the healthy body symptoms similar to those of the
patient whom we are treating ; and 2ndly, that a remedy so
selected has the power of curing even in quantities so minute
as one decillionth of a grain or drop.
The second proposition, which we may thus modify, " that
medicines have the power of curing in so great a variety of
fractions of a drop or grain that the particular fraction we
select from the 10th to the decillionth is of comparatively
secondary consequence," holds true, however, only under the
conditions that we choose a remedy strictly in accordance with
the maxim expressed in the first proposition — the Homoeopathic
formula. If we leave this narrow path traced out by Hahnemann,
and attempt to discover specifics by any other plan, then the
whole complexion of the question is at once changed. To
illustrate my meaning, let me direct your attention to an
interesting paper which appeared in a recent number of the
80 Lecture hy Dr. Russdl
" P.riti-jh Journal of Homoeopathy," by Dr. Eidd, on the treatment
of lihiijiis tuiuoure of the uterus. Dr. Badd observes, ** The
hoiiKiopathic treatment of fibrous tumours illustrates the
r^'O'-ssity we liave to treat diseases not symptomatically, but
rationally. No m^ lirine is known to cause the production of
fil»ious tunioiii-s; and although medicines such as Sabina, Secale,
and Fr-iTiim Muriaticuni, are homaH)patliic to the symptoms
caused by the tumours, yet their use is only palliative, and in
no way curative of tlie disease."
" From the pathogenetic effects of mercur}-, it seems to be
the nearest homoeopathic specific for the disease. The primary
patliogenetic effect of mercury is to cause an increase in the
quantity nf fibrine in the blood; also an increased activity in
the fibrous structure, and in the fibrous organs, such as the
woml). In practice I liave found it the most useful remedy in
the treatment of this disease." Dr. Kidd then mentions that
he gives from one to three drops of the second decimal dilution
of CV^rrosive Sublimate two or three times a day, it may be for
many months. The second decimal dilution is the 100th of a
gniin, and three drops of that three times a day would make
lh(i daily quantity of this powerful salt of mercury taken by
tlu» ])atient about tlie 11th of a drop. In this passage we
h.'iv(; two statements — the one is that of a fact, and a most im-
fjortant fact,^coming from a physician known to have had a
Vi'vy extensive experience — viz., that a given quantity of Cor-
rosivci Sublimate cures fibrous tumours of the uterus. We
]iav(; also, in explanation of the fact, the statement that mer-
cury a(;t8 lioniceoxmthically, having the power to increase the
fibrin(5 of the blood. While gratefully accepting Dr. Kidd's
fact as an important addition to our resources, and trusting
that in the hands of others this remedy may prove as useful
AH Ik; assures us it has been in his, 1 am compelled absolutely
to r<yecl his explanation of the method of its curative action,
for I liiicl all the authorities on the subject describe the action
of mercury upon the blood as the very reverse of what Dr. Kidd
Lectu/re hy Dr. RimdL. 87
aflinns it to ba So feir ttom mercuij piodaciiig an excess of
fibriiie» it causes a marked reduction in the quantity of that
ingredient of the blood. Dr. Headland^ in his well-known
prize essay on the action of medicines, makes the following
observations in regard to mercury : — " Mercury disintegrates or
decomposes the blood, and thus wastes the body. This is the
systemic action of mercuiy, on which too much stress camiot
be laid. Dr. Wright has analyzed the blood of patients under
mercurial action. It is materially changed : it contains more
water, and is more prone to putrefaction, than healthy blood.
The fibriney albumen, and red globules, are diminished in
amount." . . . Wibmer, who has collected all the cases of
mercurial poisoning which had been published at the time he
prepared his wonderfully elaborate work, mentions, as one of the
characteristic effects of mercury, " the increase of the fluidity
and decomposition of the blood," and I can find no authority
for the statement that mercury at any stage of its operation
increases the fibrine. If we are constrained to disallow Dr.
Kidd*s explanation, are we therefore called upon to reject his
facts, and the practical deduction to be drawn from them ?
Heaven forbid that we should be possessed of so narrow a
spirit. No. Let us accept these and all facts which add to our
power of coping with the multitudinous forms of disease claim-
ing our efforts to cure or relieve ; but let us arrange such fiacts
in their proper order, and call them by their proper name. If
mercury have the power of curing fibrous tumours in virtue of
its action on the blood, then it is by diminishing the fibrine in
that fluid. Now, this action is not pathological, but physio-
logical, and probably chemical ; as such it is removed entirely
out of the conditions to which the proposition respecting the
dose of homoeopathic medicines is applicable. To cure in this
way we must use comparatively large quantities, in order that
th^y may produce the physiological effect ; we have no right
to expect any action at all in this method from the minute
doses usually employed by homoeopathic practitioners. In fact,
8 S LuUrt bjf Dr. Rusidl.
« ; h '.irf:i 2lx*: not homceijpathic in any sense. Let this be
ci;.-/l:. .'!y uii«kT.':too<l, otherwise we shall find that those who
atv-:;;; * \n r^-jKirat th^^rm, anJ, ignoring this important tsjcXy em-
pl'iV t;.-: rri*:<Ii^-imr.s in such doses as thev are themselves in the
h;ii^i^ ot jiroh'jribiri;:, will l^ grit^vously disappointed in the
Kvjj!*-. I>jt us recognise as a significant sign of the times the
ri-je of Jt fo nn of sj^ecific therai>eutics entirely different from
IIoino;o|athy, and likely to have a powerful influence upon
ui^'Amaik: — Vrneficial as regards Allopathy, to which it will
naturally ally itself, and in my opinion detrimental to Homoeo-
patliy, which it will deprive of that purity and certainty so
remarkably in contrast with the vagueness and uncertainty of
all other methods hitherto introduced.
While it may be a cause of legitimate regret to see — as we
do in Gennany — a large number of men prefer the guidance of
I'aracf-lsus to that of Hahnemann, in their quest for specific
renierlies, we are bound to concede that, from their point of
vi(;w, tli(i massive dose is jjerfectly rational But we cannot
say HO much of those who adopt the principles of what I think
Dr. (Jliamhers calls conservative or constructive medicine, and
aiiempt to carry them out with infinitesimal doses. For exam-
j)le, tlidHi are some diseases in which it is known that iron
exists in (l(jficient quantity in the blood. Now, there are two
plans, both rational, for treating patients so affected. The one
— the; constinictive — is to administer iron in such a form that
it can l)(^ assimilated by tlie invalid, and restore by its chemical
ac-tion the blood to its normal state. That this is possible,
i/4 proved liy th(j rcjsearches of the chemist. The other
])lan JM to (liH(}ov(!r medicines which shall enable the organ-
ism lo appropriate} for itself the iron wliich exists in abundance
in iirMcJcH of food, if wo adopt the latter plan, then we should
nmploy infiniU'simal doses; if the former, we must give the
irnh in tunKihle (juantities. To prescribe it in the billionths
of a )/niin, is as irrational as it would be to administer the
tnillionth of a drop of tinoturft of senna to obtain an evacuation
of tlu' howoU.
Lecture by Dr. Rutsdl. 89
I now come to the consideration of the question of the
administration of two medicines in alternation — a practice
which may be said to have become usual, and which is often
adopted even by those who condemn it The short time
at our disposal will prevent me &om entering with any fulness
into this division of the subject ; and I shall content myself
with making a few general observations on the advantages and
disadvantages of this plan of treatment.
In the first place, it is so manifestly at variance with the
doctrines taught by Hahnemann, in regard to the necessity of
coimteracting one morbid dynamic change, in which he con-
sidered a disease to consist, by some one other medicinal
dynamic action, and to his belief of the length of time that a
single dose of a medicine acted, that he could not possibly
regard the plan with anything but repugnance fix)m his theore-
tical point of view. If disease be one and indivisible, and if
its symptoms be but the mutterings of this evil spirit, and if,
on the other hand, a medicine act as a whole — ^giving a shock
to this malignant spirit, as knight charged knight in the
encounters of chivalry — ^then, with this idea of morbid and
medicinal action, it was obviously inconsistent to administer
more than one medicine at a time, or to give a second dose of
this imtil the effects of the first were exhausted. But Hahne-
mann, besides being a genuine thinker, a profound excogitator
of a system derived from certain assumed axioms, was a man of
great common sense, of large experience, and of practical saga-
city. And in medicine, as in politics, the most successful
administrator is he who, although fully recognising the general
laws which philosophers have propounded, yet adopts his mea-
sures to the special exigencies of the occasion, even although
for a time they seem in violation of his most cherished maxims.
In medicine, the law of humanity is the highest of all laws ;
and Hahnemann showed by his practice that while recognising
the general propositions he had laid down in the "Organon," he
did not allow them to interfere with his freedom of action in
9 0 Lecture by Dr. Russell.
dealing with dangerous disease. In proof of this, we find that
when he treated a form of typhus fever, in the yeax 1814, he
administered in alternation Bryonia and Rhus tox. In the
edition of his Materia Medica published in 1833, he mentions,
in the introductory observations to Rhus tox, that the only
remedies which proved effectual were Rhus given in alternation
(ab wechseld) with Bryonia. Nor does he make any depreca-
tory observation on the practice So that even when he
strenuously maintained the theoretical badness of this method
of procedure, he does not impugn it in an instance in which
experience proved it to have been useful It is but fair to
observe, that although he speaks of giving these medicines
in alternation, yet, in the fuller history of the epidemic,
he describes the cure as usually effected by a single dose,
first of the one and then of the other medicine.
If, however, we reject the notions of Hahnemann, in regard
to the essential nature of disease, as incompatible with the
modern pathology which has come into existence since he wrote
his " Organon " — a pathology not, like that against which he
inveighs, founded upon conjecture, but the fruit of extensive
and accurate observation on the results of morbid changes, and
of careful inference therefrom as to the nature of the actions
which produced these organic alterations in the body — are we
therefore justified in also rejecting his practical advice, never to
give but one medicine at a time, and never to give a second
until the operation of the first has wholly exhausted itseK?
There still remains another serious objection to the administra-
tion of medicines in alternation, and that is, that it introduces
such an element of confusion into the problem of what did
good in any particular case as in some degree to vitiate the
scientific value of the result we obtain. If, in a case of acute
rheumatism, I prescribe Aconite and Bryonia alternately, and
the patient recover, how shall I determine whether the cure
were due to the action of the one or of the other, or of a
tertium quid compounded of both ? That this is a most
Case of Ovariotomy. 91
serious objection must be admitted; and the conclusion I am
disposed to come'to is, that when we adopt the system of alter-
nation it should be done always under protest. The paramount
duty of the physician being to cure, he is bound to employ the
measures which seem to him best suited for the particular case
under treatment. All other considerations are secondary to
this irrevocable^ and immutable obligation.
CASE OF OVAEIOTOMY.
Operation performed by Mr. Ayerst. Eeported by
Mr. EoBiNSON, House Surgeon.
Harriet Foster. Aged 24. Servant. Unmarried. On May
6th, 1862, was received as an out-patient under Mr. Leadam,
for Ovarian Tumour of left side, which she first noticed
eighteen months previously. Fluctuation was then indistinct.
She gradually enlarged, fluctuation becoming more diffused and
distinct, and continued as an out-patient until Nov. 24., when
she was admitted into the Hospital She then measured 36-^
inches in circumference, one inch below the umbilicus.
Tapping was not had recourse to, as she was considered a fair
subject for the major operation. She complained of a feeling of
great weight in the abdomen, more particularly when walking •
dragging pain round the hips ; much flatulence ; sensation of
hot water passing down the back ; giddiness, dimness of sight,
and headache ; excessive sour eructations ; shooting pain in the
hypogastrium. Bowels regular, but each action is followed
by much pain, as from piles. Catamenia always regular, but
attended with great pain. There was occasional hysteria.
From this date (Nov. 24) to Dec. 30, the general health
gradually improved, and it was now decided to remove the
tumour, for which purpose she was placed under Mr. Ayerst.
92 Case of Ovariotomy,
At 9 a.in. the patient was put under chlorofonn, and an inci-
sion made to the extent of 4^ inches, in the median line — from an
incli ])f»low the umbilicus to an inch above the pubes. The tumour
was brought forward, and the separate cysts of which it was
composed were tapped with the ovariotomy trocat. Some (the
larger cysts) contained a dark-brown-coloured fluid of a grumous
consistence ; others (the smaller ones) contained a thin straw-
coloured fluid. The total quantity of fluid that came from the
abdomen was about two gallons — an ordinary stable bucket-
full. The size of the mass being thus much diminished, and
there being no adhesions, it was with little difficulty pulled
forward. A clamp was applied to the pedicle, and a ligature
an inch lower down. The tumour was then removed by a
single stroke of the bistoury. The clamp was left outside, and
the edges of the wound were brought together by means of
large harelip needles and twisted sutures. The wound was
dressed with lint soaked in a calendula lotion.
Within the envelope of the ovary were found numerous
small but distinctly-formed cysts, varying in size from a pea
to a hen's egg, and containing a pale straw-coloured fluid.
1 1 a.m. — Patient complains of feeling cold and numb in the
lower extremities ; slight numbness also in right arm. Great
tympanitic distension in umbilical region. Pulse 84.
Ordered beef tea and weak brandy and water. Temperature
of the room, 65**— 70° Ft.
R. Am. \ \ 4t« horis.
1 p.m. — Pulse 112. Body quite warm and comfortable;
numbness gone ; tympanitis continues ; sharp pain at seat of
wound,* and slight nausea. Several ounces of urine were drawn
off. This was done, not because she had any retention, but to
prevent unnecessary motion of the patient.
6'20 p.m. — Pulse 120. Stabbing pain in hypogastrium ;
passed a littje urine involuntarily ; less tympanitis.
R. Aeon. 3 gtt. j. h. s. s.
Case of Ovariotomy. 93
Dec. 31, 10*30 a.m. — Nausea; vomited a small quantity of
very acrid fluid. Pulse 112.
Jan. Ist^ 1863, 9 a.m. — Pulse 120. Feels dull and low ;
complains of feeling bilious ; conjunctiv» yellow.
R. Merc. sol. \ i 2'^d» horis.
Jan. 2nd, 4 a.m. — ^Pulse 130. Excessive clammy perspira-
tion. Palms of hands alternately burning hot and cold ; feeling
of sinking.
Jan. 3rd, 9 a.m. — Pulse 120. Has had some hours' sleep; '
violent retching during the night ; stomach rejects food.
12 Noon. — Constant hiccough; stomach rejects everything;
tongue dry and brown ; feels cold, but no well-marked rigour.
Pulse 110.
R. Ipec. \ \ 2°^« horis.
4 p.m. — ^Foecal vomiting to the extent of at least two pints;
extreme chilliness and prostration ; cold clammy sweat all over
body.
R. Ars. 3 gtt. j. 2»<^« horis, and after each attack of
vomiting.
8 p.m. — Pulse 136. Feeble; foecal vomiting continues;
extremities more warm.
R. Plumb, carb. 1 gr. iij. o. h. s.
11-30. p.m. — Pulse 130. Almost imperceptible; seems
much prostrated. Vomiting has been much more frequent j
excessive jactitation.
R. Tinct. Bell. gtt. iij., in Enema.
R. Bell. \ \ tertiis horis.
Jan. 4th, 9 a.m. — Foecal vomiting less frequent. *
Jan. 4th, 6 p.m. — Seems getting worse every hour.
Jan. 4th, 11 p.m. — Pulse 150 ; quite thread-like.
R. Op. j. gtt. j., 0. h. s.
Jan. 5th, 6 a.m. — Decidedly better; slept for an hour
during night.
94 Com of Ovariotomy,
Jan. 5th, 11 a.m. — Pulse 144; considerable foecal vomit-
ing, but less abdominal tenderness.
Jan. 5th, 5*30 p.m. — Clamp removed by Mr. Ayerst; she
is now almost pulseless ; eyes within last two hours have sunk
in lier liead ; constant retching and hiccough ; cold sweats.
Ordered cliampagne, hot brandy, and beef tea.
R. Ars. J J 0. h. s.
Cataplasm to abdomen. Enema.
Jan. 5 th, 9 p.m. — Seems rapidly sinking ; is scarcely able
to hiccough ; is unconscious of what is going on around her ;
extremities cold ; tossing about in bed.
Jan. 6 th, 9 a.m. — Decided reaction ; her extremities have
become warmer ; slight glow on cheeks ; tongue less brown and
hard. Wound dressed, and pedicle ligature removed. Continue
Arsen.
Jan. 6th, 10*30 p.m. — Continues to rally; no foecal vomit-
ing for twenty-four hours.
Jan. 6th, 12 Midnight. — Pulse 150; very small; extreme
restlessness ; frequent and distressing hiccough ; slight bilious,
but not foecal vomiting ; feels ineffectual urgings to stool.
R. 01. Eecini, ^gs.
Sp. Terebenth, gtt. x. 5-
Pro Enemate.
Jan. 7th, 9 a.m. — Had several (five or six) evacuations of
hard scybala ; skin warm and perspiring ; has some swelling
of parotid glands ; she fancies she caught cold from the door
being left open.
R. Ars. \ \ 4*^ horis.
Jan. 8 th, 9 a.m. — ^Pulse 112 ; glandular swelling has in-
creased so much that she cannot open her mouth ; otherwise
continues to improve.
Jan. 8th, 9*30 p.m. — ^A profuse discharge of brownish-
coloured fluid has suddenly taken place from the lower part of
the wound ; about a pint came away at one gush ; she had
Case of Ovariotomy. 95
no pain with it, or warning of its approach ; it had a slightly
foecal odour.
Be. Aeon. L s. 8. (2 doses).
Jan. 9th, 9 a.m. — Pulse 146 ; half a pint of brownish
foecal-looking matter escaped from the wound during the night ;
she has had no sleep ; abdomen much decreased in size ; face,
gums, and mouth, painfal and swollen.
Jan. 9th, 9 p.m. — ^Pulse 128 ; bowels opened tolerably
freely about mid-day ; loose watery stool ; a great deal of brown
fluid came from wound; the wound gapes at lower part;
mouth very sore and troublesome; has great difficulty in
swallowing.
R. Aeon. I I 2""^ horis (3 doses).
Jan. 10th, 9 a.m. — Pulse 116, full; bowels slightly moved;
intestinal discharge from wound ; has had no sleep ; mouth
very troublesome; the needles and ligatures were removed,
and the edges of the wound brought together with adhesive
plaster ; takes a good deal of nourishment.
Jan. 16th. — From last report to this date the symptoms con-
tinue much the same, but indicate gradual improvement ; dis-
charge from wound decreases ; bowels act naturally ; appetite
improves, and diet consists of good nourishing food, such as
chops, beef tea, stout, wine, &c. The glandular swellings, how-
ever, increase, and go on to suppuration. An abscess pointing
behind left ear was opened by Dr. Ayerst. Has profuse dis-
chai^ from ears.
Jan. 20th. — ^Vespere ; trifling discharge from wound all day ;
pudendum inflamed, from excoriating nature of the discharge;
bowels acted three times ; no pain in abdomen.
Diet consists of beef tea, chicken broth, arrowroot, and port
wina
Jan. 22nd. — Has had troublesome cough last night, and feels
low and weak.
Be. Hep. SuL 1 ^ 4*^ horis.
Jan, 23rd. — Slept tolerably well ; two natural motions \ but
96 Case of Ovariotomy.
little discharge from wound ; it heals rapidly at upper part ;
complains of plilegm in chest ; tongue much cleaner, but dry,
and slightly aphthous ; glandular swellings much diminished ;
immense discharge from both ears.
Continue Hep. Sul.
Feb. 4th. — From 23rd of January to this date she gradually
improves, when the report is as follows : — Bowels acted largely
last night ; discharge from the wound for the last three or
four days has been much less ; skin soft and cool ; tongue
still slightly aphthous; wound, healed up to one inch; a
conical piece of cork, covered with lint, soaked in calendula
. lotion, was applied to the wound.
Continue Hep. Sul.
Vespere Aeon. (1 dose).
Feb. 7th. — ^Pulse 115; looks much better, and feels so;
discharge from left ear quite ceased, and from right nearly so ;
bowels acted once ; plug removed to be cleaned and re-applied.
Since its application the stools have been doubled in quantity,
and much more natural in appearance. She enjoys much com-
fort from the plug. Yesterday, sat up from 12 to 4 o'clock.
Feb. 13th. — Had a good night's rest; no discharge from
the wound of any kind; cough easier; tongue clear, and
quite free from aphthae ; appetite good ; sits up daily.
From this date she went on steadily improving, and was dis-
charged on the 27th, cured.
N.B. — Additional information in regard to this interesting
subject will be found in a paper by Mr. Leadam, published in
"the second volume of the " Annals."
^nitals af i^t ^atxtiri.
THE POSITIVE SERVICES OF THE SCHOOL OF
HAHNEMANN, EXEMPLIFIED IN THE TREATMENT
OF ACUTE INFLAMMATORY DISEASE.
By JOHN OZANNE, M.D., Guernsey.
Gentlemen, — In the summer of 1860, a remarkable scene
occurred at one of the sittings of the Imperial Academy of
Medicine, at Paris.
In the course of a speech, M. Malgaigne used these words : —
" Alas for the Medicine of the present day ! It forgets to
study disease, and looks to pathological anatomy alone for its
indications ! Without being aware of it, its therapeutics are
nothing more than a jumble of contradictions, the produce of
the theories of all ages. Hence it has come at last to such a
point, as to number, in one of our hospitals, fewer successes
than Homoeopathy has achieved."
Here M. Barth exclaimed, with energy, " That is a falsehood!"
Numerous and tumultuous protestations to the same effect
proceeded from other members.
M. Malgaigne replied, " I hope you are right ; but still my
statement may be true."
This Society needs scarcely to be reminded, that the homceo-
pathic practice here alluded to, was that of one of its corre-
sponding members, the late Dr. Tessier.
The state of feeling depicted by the above scene, in an
assembly numbering among its members the principal hospital
physicians of Paris, had not arisen without an adequate cause.
VOL. in. 7
98 Dr. Oztnnir on the Positive Services
III tlie yo«ir 1850, Dr. Tessier, a man well and honourably
known in tlic medical profession; in his earlier days, the
favouriie pupil and friend of Dupiiytren ; and, subsequently,
pliy.->ici;in to the hospitals of Paris; published, in a book on
rii(if//tnni(( and Cholera, the results of his experience of homoe-
(•pathii! treatment in those diseases, at the Ste, Marguerite
Hospital.
These results were of the most satisfactory character, and
were entirely i)roduced by infinitesimals in the form of globules.
The worst part of the matter, however, was that they could not
be denied. Neither could the diagnosis of the disease be called
in question ; the cases having been drawn up by internes
whose anti-homceopathic tendencies rendered their testimony
uninipeacliable in the eyes of the Academicians.
Although Dr. Tessier's results were far superior in pneu-
monia to those obtained by a rigid adherence to the favourite
antiphlogistic treatment of the day, it would not do to admit the
superiority of Homoeopathy. The new system was too much
disliked to allow of such an acknowledgment. It was far
better to throw the w^hole blame on the prevailing method of
treatment. Therefore M. VaUeix, also one of the physicians
to the Ste, Marg^ierite Hospital, declared his conviction that
pneumonia was a disease of much less gravity than was usually
supposed, and would get well, in general, of itself, if the efforts
of Nature were not interfered with. Others followed him, and the
opinion gained ground, that the usual antiphlogistic treatment
was probably more hurtful than beneficial.
The same thing occurred at Vienna, but in a higher de-
gree. The results of Dr. Fleischmann's practice at the Gum-
pendorf Hospital, by unsettling the usual notions in reference
to the treatment of inflammation, led many to the extremes of
scepticism. Among the leaders of the latter school at Vienna,
I may especially mention Professor Skoda, of the General Hos-
pital, and Dr. Dietl, of the Wieden (since then removed to
Crac.ow).
f>f the School of Hahnemann. 99
Skill, in Pcuis, medical scepticism has not, I believe, roachi'd
such a height as either in Germany or in this country. Owiiij^
to the number of rival professors, claiming each to l^e the leader
of a school of his own, and impi*cssin<4 his views on studfjiita
both as a lecturer and as an examiner, H(»ina>opaihy has (to my
mind at least) hardly influenced the general tone of mind to
the extent we might suppose, if w^e judged from the numl>er of
its professed adherents. The consequence of this state of things
is, that while, in every-day life, all unite against HouKuopathy;
in the scientific world, she takes her jJace as one of the rival
doctrines, attracts less notice, and does not produce the same
extent of avowed scepticism among her antagonists. Hence,
her great faith in the one leading principle — similia mnilibiis —
and in the power of infinitesimals administered in accordance
with that principle, does not aw^aken in the same degree that
spirit which can alone arrest her progress — ^the spirit of
scepticism.
In Edinburgh, medical scepticism in the ranks of the
dominant school reigns triumphant, as we shall see presently,
when we notice a series of cases brought forward by one of the
professors in the University of that city. In my opinion, the
great impetus given to Homoeopathy in Edinburgh, more than
twenty years ago, by Drs. Francis Black and Eutherfurd Russell,
and subsequently by the conversion of Professor Henderson,
fully accoimts for the fact.
In London, the labours of our colleagues and the establish-
ment and continued existence of our Hospital has produced a
similar influence on the minds of the most advanced in the
dominant part of the profession.
It is painful to think how men of learning, endowed "svith
every qualification requisite to form a correct estimate of the
value of the Homoeopathic principle, are prevented from enter-
ing upon a systematic inquiry into its claims by the ignorance
and consequent prejudice of the profession at large. An
inquiry of the kind, undei'taken by some of the leading men in
* .T».. w
Km I)i\ Ozanih' on the Posliire Sn-'viccs
til.' (loiuinaiit. siliool, and systcinatioally earned out, during a
short iM-riod (»!' years, ^vnuld,^ve cannot doubt, lead to a final settle-
ment (»r the (p'.cstion al issue Lelwoen the two schools. Tlieiso-
li.tctl iHorls of individuals are comparatively of little avail in
coiiv.rt iuL^ opjMMicnts, Ijowover beneficial they may be in confirm-
iim Ixliivcrs. 1 have felt this most keenly for several years
]);ist, in tho course of my statistical investigations. As an indi-
vi(hial in<iuircr,T cannot get access to documents in the possession
(.r ]>ul)iic hospitals, which a commission invested with authority
by the dominant school could easily procure ; nor, had I all the
most conchisivti facts in my x>ossossion, could I obtain thehear-
ini;- which would be readily awarded to public commissioners.
r>ut since we cannot command on the part of our antagonists
the atlonlion which our system deserv^es, we must needs be
content to plod on, working with what materials may fall
witliin our reach, and addressing ourselves to those who are
suiiieiently devoid of prejudice to give us an impartial hearing.
I'lie vital question of the day as regards the Hahneman-
nian doctrines and as propounded by our adversaries — ^by the
Forl^eses, the Balfours, the Bennetts, the Simpsons, the
Gairdners — is this : — Are the cures observed in patients under
homceopathic rule to be ascribed to nature or to art ? or, in
other words, are the successes obtained by that mode of practice
2WHitive, or negative ? While we assert their positive character,
our adversaries declare them to be negative, or simply due to
the absence of injudicious and injurious treatment.
I might appeal, if I wished to evade the principal difi&culty,
to the broad fact that Homoeopathy exists as a distinct, a well-
established, and a progressive school, represented by a numerous
and an increasing body of medical men. But such an argu-
ment would not satisfy the doubts of a thoughtful and tho-
roughly candid inquirer. The progress of our school through-
out the civilized nations of the world, and the numerical
strength of its members, would assuredly be an argument in
its favour to a considerable extent ; but as the dominant party
still grftuily 5jwpass us in numbers, it is an argument they are
of the School of ILihanannn.
10]
everyday using agiiinst us, ami wliicli, innsojiucntly, wnuM ]«■
of little power in our hands. The stivn^^tli of tlieir i»o>itiuii
consists also in their holding most of tlio public in.-jtilutioiis
which give influence and authority io the nuulital profrssifni,
and not in their scientific right to lji»M them. X«*\vrtlji-h-ss,
as they have tlux)ughout made use of th«*.s<' advantai^'fs, wiih thr
determiaation to crush us if possibU*, and as th<»v Iiavo not suc-
ceeded, it will afford some presumptive evitleiici; of the vitality
of the truths which Homa^opathy cmhi-sici-s to take a glainc at
the statistics of our adherents in different parts of tlie world.
A. — ^The present position and devilojMnont of the; houMo-
pathic school
According to Catellan*s " Annuaire irom<uoi)athi(iue ** for thr
present year, the accuracy and trustworthiness of wliich we havi*
every reason touphold,^^ the number of medical men i)nutisin[^
Homoeopathy in various parts of the world amounts : —
In North America
to
1G55 (No information sinci*
„ the West Indies
»
32 the war.)
„ South America
>»
131
„ the British Isles
i>
283
„ Belgiiun
>>
40
„ Spain
»
192
„ Italy
»
lOG
„ the Netherlands
»>
14
„ Portugal
»
57
„ Eussia
»
vr>
„ Switzerland
»>
37
„ Parts of Asia
yy
4^
From these various
„ Denmark, Norw^ay,
Sweden
>»
14
]>ai*ts no precise in-
„ Moldo-VaUachia, Turkey
a
5
-forniati(m could he
„ Poland
»
21
obtained by ^lessrs.
„ Various other places
»
9.
Catelhm, freres.
„ France
»
441
„ Grermany
yy
554
Total
3761
• There are, of course, here as in all works of the kind, a small
number of errors; but this does not affect its general testimony.
102 Dr. Ozanne on the Positive Services
Xoto. — In those tables the United Kingdom figures for an
incivaso of 78 practitioners over the preceding list published
in 18G0.
As th<* total in 18G0 was 3G15, these tables show an increase
of 14G.
In viewing these tables, and allowing for errors, for changes of
residence, for the continued insertion of the names of persons de-
ceased, we cannot help being struck by the largenumber of medical
men who have adopted and put into practice the system of Hahne-
mann. Indeed, the fact that the new school carries it out uniformly,
in different parts of the world, among peoples distant from each
other, speaking different languages, pix)fessing different religions,
and often hostile to, or in actual warfare with one another ; that
it increases notwithstanding its opposition to all previously es-
tablished notions ; and that it could not exist as a body of prac-
titioners, if millions of people did not adhere to it, even when
in peril of their lives, speaks most strongly in favour of the
benefits conferred by its instrumentality.
In the face of evidence of that kind, how paltry is the
opposition, how miserable the pettifogging of our statistical
adversaries ! Need we, with such facts, be liable to the impu-
tation that we are attempting to build up the homoeopathic
edifice upon a fictitious foundation ! Nevertheless, let us glance
briefly at the scientific aspect of the question.
B. — The statistical evidence supporting the positive ser-
vices of the homoeopathic school, in the treatment of acute
diseases.
Long ago we heard it stated by Balfour, Forbes, Routh, Ben-
nett, Simpson, Gairdner, and others, that whatever favourable
results were observed under homoeopathic treatment, were due,
not to any virtue our medication possessed, — for it was asserted
to be positively wortliless, but to the fact that pneumonia, left
to itself, nearly always got weU. This has been dinned over
of the School of Hahyuinann, 103
and over again into our ears. First we heard of Dietl, who, at
the Wieden Hospital, lost only 7i per cent, of his cases ; and
then of Bennett, whose success was something most startling,
having been obtained at the Edinburgh Royal Infimiary, where
anything like error or deceit was impossible ; even setting aside
the oft told tale, that regular practitioners could never have
any wish to deceive ! More recently stiU, we heard of a paper
read before a Medical Society at Edinburgh, containing a large
series of cases, treated by a method all but dietetic, and yet
presenting results of the most admirable description. These re-
sults having since then been published in Dr. Bennett's Lectures
on Inflammation, in the Lancet (May 30, 1863), we are ena-
bled to ascertain their precise character, and the nature of
the remedial measures applied. Dr. Bennett's statements
are so startling, that I cannot forbear transcribing them
here.
"My practice is directed to support the strength of the
economy, never to weaken it in any stage by antiphlogistics ;
although, if dyspnoea be urgent, cupping or a small bleeding
may be practised as a palliative, more especially in bronchial
or cardiac complication. During the febrile excitement, mild
salines are administered. On the fourth and fifth day, when
the fever abates, good beef-tea and nutrients are given ; and on
the pulse becoming soft or weak, from four to eight ounces of
wine daily. As the period of crisis approaches, slight diuretics
are given to favour the excretory process.
"The results of this practice in 105 cases of pneumonia in
adults consecutively treated by me in the clinical wards of
the Eoyal Infirmary, during the last fourteen years, are as
follow : —
"KTumber of cases, 105. Deaths, 3 ; aU complicated cases —
one of intestinal ulceration, one of Bright*s disease, and one (a
drunkard) with delirium tremens and cerebral meningitis. Eatio
of deaths, 1 in 35 cases. Average age of cases, 3I3 years.
11)4 Di\ Ozannc on the Positive Services
Sini^le iincomplioated cases 58; duration averaged ISj days
J)uul>k'iiiicuinplicatod cases 19; „ „ 20 „
('niiij)li(ated cases 17; „ „ ISs „
Uiisali>iactoiy cases as to 1 ^
ilurtitioii j
Ociitlis 3
105
Sul)j5cciucnt cases, all re- \
(.'overed, mentioned in > 10
a note (loc. cit. p. 600) )
Total 115 cases, with only 3 deaths.
'* Average residence in hospital of 77 uncomplicated cases of
pneumonia (single and double), was 22^ days. (This is too
higli: some linger from weakness, from subsequent attacks of
rheumatism, or skin disease. One remained in a fortnight after
recovery from having no shoes, &c.) "
"It has been supposed that in consequence of this compara-
tively small number of cases, ranging over so long a period as
fourteen years, the disease is rare in Edinburgh ; but it should
be explained that the clinical professors are on duty alter-
nately ; and as regards myself, I have never acted as physician
to the Infirmary more than one-half the year, and in most
cases only one-third of the year. Again it has been supposed,
from the small mortality, that the cases there are unusually
slight and trivial, or that the disease is not extensive. But it is
not so. In Edinburgh now, as formerly, many, and especially
the double cases of pneumonia, have been very severe, with great
dyspncea and very urgent sjonptoms. I have also frequently
X)ointed out instances of the pulse being hard and strong in
vigorous young men, in whom, however, most rapid recoveries
were invariably observed. It should also be noted that these
cases were in no way selected, but do not include a few which
were admitted in extreynis at night, and never seen by the phy-
of the ScJiool of HahnematifK 1 05
sician, nor such as were partly treated by other physicians in
the hospital, and for which treatment I am not responsible."
I do not wish to cast the least doubt upon the authenticity
of these cases, nor upon the correctness of the diagnosis. At
the same time I feel it is not out of place, in the face of the ex-
traordinary success of Dr. Bennett's dietetic treatment, to point
out some circumstances which throw a shadow over the picture,
and which require that we should reserve our conclusions until
we get full explanations regarding all that has taken place at
the Eoyal Infirmary.
1st. A few cases admitted in extremis at night, and never
seen by the physician, are not included.
This admission is full of significance. The expression " a few
cases," when a total of over 115 is under consideration, must
mean, one would think, 5 or 6, or perhaps 7, or even more. But Dr.
Bennett would say — It matters not how many, since they never
came under my observation. Granted, but they must have been
seen by his clinical clerk, or some other of his assistants, who, faithful
to the creed of the Professor, would not put the patient under
the old-fashioned antiphlogistic measures, but would give "good
beef-tea and nutrients," or perhaps " from four to eight ounces
of wine ;" in other words, the Professor's own treatment would
be brought to bear on the moribund. Such cases ought not to
be excluded ; at any rate, their number ought to be stated, and
they might thus be made to constitute a separate category.
This argument acquires additional force, if we take into con-
sideration the tables of Dr. Fleischmann's Homoeopathic Hos-
pital, so often quoted in controversial statistics. I quote the fol-
lowing from the reports for the year 1850 and 1851, printed
for circidation in Vienna : —
In 1850 there were 1084 admissions, consisting of cases of
all kinds ; and besides these, 4 patients brought in dying.
In 1851 there were 1041 admissions ; and besides these,
3 patients brought in dying.
100 hr. (fzannc on the Positive Services
III bnth yoars, — cases of all kinds, 2125 ; brought in dying,
7;— totiil, L>i:J2.
'J'Ih:; putioiila in extronis thus constituted at Dr. Fleischmann's
l-:3U4tli of the whole numlxjr of cases ; whereas, with Dr. Ben-
nett, if we put down his morihiuid at 5, which is the least we
can d's frum his statement, they would constitute l-23rdof the
whole number.
fu the Ilomreopathic Hospital, 1 moribund to 304 cases of
all kinds; at the Eoyal Infirmary, 1 moribund to 23 cases!
Can these statements of Dr. Bennett's go forth unchallenged ?
2nd. The cases partly treated by other physicians before Dr.
Bennett ought to be cited with the results. No one can resist
the feeling, on reading the whole of the paper, that Dr. Bennett's
cases gave l)y far the best results ; if so, how could his colleagues
be so blind and negligent of their duties, as not to perceive the
advantages of the dietetic treatment, and apply it to the patients
who fell into their hands ?
3rd. The average age of the patients, 3I3 years, is a very fa-
vourable one — much more favourable than in Tessier's cases.
4th. The number of complicated cases, 3 in 115, is very
small, if we are to believe the allegations of Dr. Eouth in his
" Fallacies."
With these remarks or objections we must take Dr. Bennett's
cases for what they are worth. I have endeavoured to procure
the statistics of the Eoyal Infirmary since Dr. Bennett's investi-
gations began, but have been unable to do so ; therefore I can-
not compare them with similar cases under the other physicians,
and under treatment not so purely dietetic.
Statements such as the above completely unsettle our
notions in reference to the gravity of pneumonia, when not
injuriously interfered with by medical art. Yet we must ac-
cept them, with the reservations I have made, until further facts
are brought forward to contradict them.
So far they do not afifect our statistics of pneumonia. The
course of pneumonia at Vienna and at Paris being very different
of {lie School of Hahnemann, 107
from what it appears to be at Edinburgh, we must compare
allopathic or dietetic results in either of those towns with tlie
homoeopathic in the same place : thus our statistics will in no
way be affected by the Edinburgh returns.
But before I proceed to ascertain the mortality of pneumonia at
Vienna or at Paris, under simple dietetic treatment. I will call
the attention of the Society to a singular circumstance, which
brings me back to the quotation at the head of this paper.
It would seem that the non-gravity of pneumonia had been
accepted by many physicians in France ; and among the writers
on that side of the question, we may mention Dr. Barthez and
Dr. Bourgeois (of Etampes), besides the late Dr. VaUeix.
This state of feeling was reflected in the Imperial Academy.
Hence, the subject proposed for one of the prizes to be com-
peted for in 1862 was: — "Expectancy in the treatment of
pneumonia."
It is remarkable that no essay of a sufficiently conclusive
kind was sent to the Academy, either from Edinburgh or from
Vienna, or from the pen of Dr. Barthez ! The prize, therefore,
was not awarded.
Under the circumstances, we can hardly believe that all the
supporters of the spontaneous curability of pneumonia, in nearly
all cases, are really in good earnest. The suspicion that cases
are classed and weeded of patients in extremis, so as to support
a favourite doctrine, naturally arises in our minds.
In different localities there are medical constitutions, which
cause much variation in the percentages of deaths in individual
diseases and on entire populations.
Professor Christison, in his admirable address to the Associa-
tion for the Promotion of Social Science, at one of its meetings
recently held at Edinburgh, stated that in Scotland the average
mortality on the whole population, for the " seven years ending
with 1861, was 1 in 48; whereas, in Lower Austria, the
deaths actually reach 1 in 21\r ^Lancet, Oct. 24, 1863.
Yienna being in Lower Austria, we should, therefore, ex^^eci
1 US Dr. Ozanhc on the Positive Services
tu liiid a lii^'lier perctMitage mortality tl:an in Scotland. Per-
hajjs thi"- may explain to some extent Dr. Bennett's astonishing
succM'Ss. 15iit, even here, we were tolil from all sides that
l.iM.'UiJiniiia left to nature was rarely a fatal disease.
Dr. Di«.tl, in his book intituled " Der Aderlass in der
Luuc^ouentziindung," published in 1849, declared his mortality
among i)atients under simple dietetic treatment to be only 7
and 4 tenths per cent.; whereas it was 20 and 4 tenths in
those who were bled, and 20 and 7 tenths in those who were
placed under a course of tartarised antimony. These assertions
startled us all when they were first made. But subsequent ex-
perience (under another physician, I beheve) greatly modified
the aspect of the matter.
I c]^uote the follo^ving facts from Dr. Arthur Mitchell's report
in the Ediiiburgh Medical Journal for November, 1857. The
moitality of the same hospital, in 1854, when " the treatment
was symptomatic and exceedingly simple," averaged, in pneu-
monia, "no less than 20 and 7 tenths per cent." So much for
the boasted spontaneous recoveries in pneumonia !
Professor Skoda, of the General Hospital, Vienna, was said
to have considerably reduced his mortality in pneumonia by
discontinuing blood-letting and other active measures, and by
substituting simple dietetic treatment as the rule. Now, what
are his results ?
Dr. ]\Iitchell (loc. cit.) says, in a note : — " During the same
year, 1854, under Skoda's treatment, out of 53 cases, 31 were
cured, 8 bettered, and 14 died. Of these the disease lay 13 times
in the left side, giving 10 cures, 2 deaths, and 1 improvement.
It occurred on the right side 19 times, and of these 14 were
cured, 4 bettered, and 1 died. In 12 cases both sides
were affected, and of these the greater part died. '9 cases were
complicated with extensive pleuritic exudation, and of these 1
was fully healed, 2 were bettered, and 6 died."
During a series of 10 years, ivom. 1847 to 1856, there were
achiiitted into the General Hospital, of which Skoda's wards
of tlie School of Hahnaiuuni. 1 ()!♦
form apart, 5,909 cases of pneumonia; of those 1439 died.
One death in 4 and 1 tenth cases, or 24 and 4 tenths deaths
per cent.
It seems unaccountable that the simplest possible ti-eatment
an allopath could devise, should be att<3nded l)y a moi-tality of
20 or 25 per cent, at Vienna, and by one of less than
3 per cent, at Edmburgh (even if we put down the gener.il
mortality at 1 in 27 in Lower Austria, and 1 in 48 in
Scotland).
But the allopathic mortality of Vienna is not greater than is
met with at home under the best alloimthic treatment. In the
years 1852-3, there were admitted into St. George's Hospital,
London, 91 cases of pneumonia — the deaths amounted to 30.
Out of this number, 46 cases were entered as complicated —
22 of which died. To ascertain the mortality of the uncom-
plicated cases, we must deduct the complicated cases from the
total of cases, and the deaths among the complicated from
the total of deaths (as the deaths in the uncomplicated arc not
given in the tables). We thus obtain the following residues for
the uncomplicated cases : — Uncomplicated cases 45 ; deaths 8.
This gives 1 death in 5 and 6 tenths cases, or 17 and 7 tenths
per cent.
A mortality of 1 7 per cent among the uncomplicated cases,
at St. George's, fully accounts for Skoda's mortality at Vienna.
But how does it tally with Edinburgh ? Is it that 14 or 15
per cent, are bled or blistered to death at St. George's ? or is it
that there has been some mistake in the books at the Eoyal
Infirmary?
It is impossible to doubt that our Scottish allopathic friends
are given to blundering, when they deal with medical statistics ;
especially if they have before them some disagreeable homceo-
pathic results which it is urgent to explain away.
In the British and Foreign Medical Revieiv, for October
1846, p. 590, Dr. Balfour asserted that Skoda's mortality was
6 and 6-10th8 per cent. ; and in the next page he informed us
1 1 \) Dr. Ozannc on the Positive Servicer
thai Skoda coii-sidiTod 1 in 8 as his nsual proportion of
deaths. L<*t us see what thcso assertions are worth.
Al»out thive years ago, Dr. Gallavardin, physician of Lyons
in France, j»ul>lished a pamphlet, intituled "De TEnseignement
C'liiii^ue en Alleniagne," containing an account of his visit to
th(^ niediral schools of the Universities of Vienna, Dresden,
Cracow, c^'C.
AiiKjiig other questions he ascertained the results of the
treatment of Skoda and others in pneumonia. He found that —
1st. — Those who had observed Skoda's cases during the
winter of 185-4-5, universally declared that he had lost 1 out
of every 3 cases of inflammation of the lungs — say 3 3 per cent.
2nd. — A Vienna physician informed him, that at his ex-
amination for the doctorate, Skoda avowed that he lost 1 out
of every 5 of his pneumonia patients — say 20 per cent.
3rd. — On mentioning this to Dr. Walter, the chief physician
to the General Hospital of Dresden, and a disciple of Skoda,
tlie Dresden physician shook his head, and said : " If he only
loses 20 per cent, of his pneumonia cases, it is that he has been
very fortunate."
4th. — The students and physicians who attended the clinique
of Oppolzer, at the Vienna General Hospital, agreed in esti-
mating his mortality in pneumonia at 1 in 5 — say 20 per cent.
It is singular that the results of Oppolzer, who carried out a
moderate treatment, but quite allopathic, should approximate so
closely with those of Dietl, of Skoda, and of Walter, who belong
to the so-called physical school, and have no faith in the ordi-
nary remedial measures of the allopathic schooL
These results are of the highest importance, as they clear the
way for our homoeopathic statistics, so far as Austria is con-
cerned, and enable the statistician to estimate the positive and
undeniable curative influence exerted by homoeopathic remedies
upon acute diseases.
Let us now inquire into the allopathic mortality in pneu-
monia at Paris.
of the School of Hahnemann, 111
I am sorry to say I cannot procure any statistics of the
results of simple dietetic treatment. Nor can I give any ex-
tensive allopathic statistics since those of GrisoUe. They are
not to be found. It would seem as if our allopathic bretliren
dread to publish the full statistics of their hospitals. But the
following admissions, taken from the "Gazette des Hopitaux"
of Paris, for the 7th Feb., 1863, and from the "Bulletin de la
Soci^t^ des HSpitaux," and reprinted in the "Art M(5dical,"
April, 1863, are most valuable : —
" Pneumonia has been frequent and severe ; the cases have
amounted to 140. of which 61 died — more than one-third. In
children the mortality was one-half, and in aged persons two-
thirds."
Granting that this mortality of 43 per cent, was quite ex-
ceptional, which must have been the case, enough is left, if we
deduct the extra-gravity of the cases, to show that pneumonia
is at Paris, as well as at Vienna, a very serious disease, and one
frequently terminating fataUy.
Whatever the " Physical School" in Germany, and the die-
tetic doctors in the United Kingdom, may say, as an argument
against ns, the results of homoeopathic treatment, when con-
trasted with the above, are such as to fill the bosom of every
honest disciple of Hahnemann with justifiable pride and satis-
faction.
The earliest homoeopathic researches of the late Dr. Tessier,
when he was as yet very inexperienced in the new kind of
practice, may be safely compared with those of Dr. Bennett.
Tessier's published cases in his work were 41 in number, with
3 deaths.
We have here no mysterious number of patients in extremis^
no cases attended by other physicians in the hospital ; all are
mentioned, and their phenomena recorded in full. And yet
here we might with more reason plead the mischief of previous
treatment than Dr. Bennett can do ; for some of Tessier's cases
had been bled before their admission — a proceeding now recog-
112 Dr. Ozanne on the Positive Services
iiisod as injurious. Again, what were the 3 cases terminating
in (loatli ?
The first was tliat of a man, 43 years of age, who, after the
liuvcjlution of February, 1848, had been exposed to difficulties of
evciT kind, often suffering from want of food, and whose con-
stitution was broken down when he was seized with pneumonia.
He was taken to the Hospital on the 6th day of the disease,
and first seen by Tessier on the morning of the 7th. His case
was one of double pneumonia, with grey hepatisation of the whole
of the riglit lung, and purulent effusion in the cavity of the pleura.
The second was that of a night-man, 60 years of age, who
had been ill a week when he was brought to the Hospital If
Dr. Bennett's dietetic treatment had been of any service, this
man ought to have recovered, for he kept quietly in bed at
home, abstained from food, and took gum water, until he be-
came so bad, that he had to be carried to the Hospital
The tliird case was that of a woman, aged 58, addicted to
drunkenness, who was brought into the Hospital with delirium,
and unable to give any account of herself. She had purulent
infiltration in the upper lobe of the right lung, red hepatisation
of the middle, and congestion of the lower.
At Vienna, Dr. Fleischmann admitted in the space of 20
years, from January, 1835, to January, 1855, no less than 1058
pneumonia cases into the Gumpendorf Hospital At the latter
date there remained 6 still under treatment ; we thus have 1052
cases, with 48 deaths, — or 1 death in nearly 22 cases, or
4' 5 6 per cent.
Dr. Wurmb's mortality at the Imperial Homoeopathic Hos-
pital, Leopoldstadt, Vienna, was for a long series of cases under
46 per cent.
These results, contrasted with those we have adduced as the
true dietetic or allopathic results at Vienna, prove beyond a
doubt, not only the positive curative power of homoeopathic re-
medies, but also their immense superiority over all other known
means of medical treatment.
of the School of Ifahn^nwvn. 1 1 M
I think I have proved by undcniahle evidence: — 1st, Tli;it
under any mode of treatment, pneumonia is always a disease of
considerable gravity. 2nd, That the superiority of the honuio-
pathic results over those of any otlier kind of trcatment, not
excepting the dietetic, is so great, tliat no doubt can (ixist of tlie
positive curative influence jjossessed by homfoopatliic remedies,
in the course and termination of the most serious acute diseases.
3rd, That this positive and beneficial inlluence becomes most
conspicuous, when all the facts brought in by adverse statis-
ticians, to confuse the question, are reduced to their proper
level.
As a final result of tliis inquir}'- we find that it is not witli-
out reason, that so large a body of medical men throughout the
world have adopted Hahnemann's mode of practice, and tliat so
large a portion of the human race acknowledges its benefits.
DISCUSSION.
Mr. Yeldham said, — The great power of Homceopathy in con-
trolling acute diseases, and its superiority over the allopathic
plan of treatment, were facts so well established amongst Iloma^)-
paths, as to require no demon stratioiL Whilst, therefore, Dr.
Eussell was readiug Dr. Ozanne's paper, he had j(jtted down
what appeared to him some of the most evident reasons by
which that superiority might be accounted for. In the first
place, the seizure of an acute disease was commonly sudden
and violent, and fell upon persons i)reviously in ordinary
healthy. The reactiiDn against the morbific impression was
proportionately violent, and frequently resulted in an attack
of inflammation of some particular organ — the lungs, the liver,
the bowels, the throat, &c. This inliammation tended to the
rapid destruction of the organ ; and if the part attacked was a
vital part, to the destruction of life also. Now, the ordinary-
plan of treating these attacks, until a recent date, was almost
universally by bleeding and other depressing agents. The result
was exhaustion of the vital power and death : the homoeo-
pathic plan of treatment, on the contrary, acting in conformity
with nature's efforts — ^Kke helping like — sustained the i)owers of
the system, and conducted the inflammation to a healthy issue.
Another reason might be found in the fact, that the symptoms
of an acute disease, as well as those of the remedy, were clearly
and distinctly marked. The relationship between the two was
1 14 Dr. Ozannc on ihr Po.'iitive Seyn'iers
<lisiiii( 1, uimI thuru was l»ut little dilliculty in selecting the right
iviiMtly. Turn now to chronic diseases: — ^Although we might
\v\'' liistitiit«' advantagi'ously a con)i)arison with the old system
:is to tla* r«'<uhs of our treatment, the superiority was less
iii;irk«(l tlian in acute disordei^s ; and lor these reasons, chronic
«!!•<. 'iis".s wci'<* coTiniKjnly insidious in their accession, and slower
in tln-ir ]>roLn*»'Ss — so insidious and slow, that the ^mtient often
did nut iilt«*n«l to them until they had established a firm hold on
tlif system. Tliou^di ai)j)arently localized in their seat, they
wcio nlutn hlood diseases — obscure in their origin and nature,
('nnij)h"cated and indistinct in their symptoms. Under such
cir(Ministanc(»s, it was manifestly very difficult to apply the
hninn'ujMiihic law with certainty; and, indeed, in many cases we
h;nl jit ])rcscnt no renuMlies bearing distinct and unmistakeable
rclntionshij) to tlie disease. But where the relationship was clear
and well marked, — as, for example, between chronic stomach
allections and such a medicine as Nux Vomica, — ^then the result of
our treatment was all that could be desired. Out of the sphere
of medicine, moreover, we, as Homceopaths, w^ere compelled to
resort to tlie same class of auxiliary means as our Allopathic
brethren, — care in diet, change of air^ change of scene, bathing,
and tlie like. Although we often cured chronic disorders which
balllcd the old school, yet, for the foregoing amongst other
reasons, our superiority was less striking than in the treatment
of acute disorders.
Dr. Hughes said, — I fully agree with the author of this
(nooning's paper as to the inestimable service rendered by the
sclinol of Hahnemann to the treatment of acute inflammatory
diseases. The specifics with wdiich Homoeopathy has taught me
to combat these disorders are to me a source of daily delight
and thankfulness. I do not, however, rate very highly the value
of statistics as demonstrative of the success of our treatment in
this direction. For statistics to prove anything, the phenomena
whose sequence they classify must be uniform and unvarying ;
and in comparisons made by statistics, every particular must be
taken into account, and must be identical on each side. How
impossible this is in such a subject as the treatment of disease,
it is easy to conceive. I think it very desirable that, so far as
statistics go, they should be shown to be favourable to our cause ;
and therefore, Dr. Ozanne merits our sincere thanks for his past
and present labours in this field. But I believe that a few well-
fletailed cases of acute disease, homoeopathically treated (as, for
instance, those in Mr. Yeldham's book), will do more to enlighten
the ignorant and convince the gainsaying as to the merits of our
system than all the statistics in the world. In one particular,
hr)wever, I fear that zeal for our cause, or imperfect intbrmation,
itf the SchiMtl nj lln}' iV)ivni ,k . \ \ Ji
has led Dr. Ozanue to inisunderst.-iinl tin* iM-.niiii; ..f tli.. -t.i!i.:ics
he lias collected. I ivfor to tlmsr (•!' l>r. MiiL-lifS lliim.-!!. nf
Edinburgh. Dr. Ozaiiiit' citi*s tin* ims.s nf tliis l":i?1'-i:imii ;is
instances of expectant or do-noiliin;,' tiiatnu'iit, .ind uliil*- Wini-
dering at their low rate (►!' iiiortality Z in In."- . suo._.,..t^ t}i;i?
pneiiiiionia miust he a l<*ss sfiious diM.'ji>«' in KdiiiliU]L:li than in
Vienna, since Dietl's mortality under ivxinTiant triaiiii«nt was
ahout 9 per cent. lUit Dr. IJmnctt ]nits Inrtli liis (.(-••> ;•- illus-
trating, not an exjK'Ctimt, l»ut a .s///7'0/'////'/ ti'-atnun; mT arm.-
disease. As soon as tlie jnilsj* "^nows ><»rt, wi- ;ri\'- nuiiiiiii-.
freely, and a moderate allowance of wiiu-. lli- nini-Miv. r cum-
mences his treatment hy the adniinistratinii nf ^mall tluscs nf
Tartar Emetic, which we know to 1)«* a true ln'iiKiujiati:!-;
specific in pulmonary inilaniniati(»n. Dr. ru'mnti', siati-iii-*,
therefore, give no sujjjjoi-t to t'Xjiectancy ; Init tiny >li«»\v
the value of a treatment, tlie o|)])osite of Inwrrinu' in a-iit*'!
disease, especially when conjoined with the admini-tiatinn nf a
specific homoiopathic to the niorhiil couditinii. In Die-l^ cases
no drugs were given; hut the i)atient.s were ki-pt uj»oii low tliet.
A similar i)lan as to suppoil seems to have he«'ii carried out l»y
neischmann, whose mortality was ahout o jjcrcent. I cann<it,
moreover, agree with Dr. Ozanne in the eoM and averted ^rjmKMi
he gives to the expectant school of nK-ilieiue. 1 helieve it is the
true stepping-stone to Homoiopathy. The ]»]iysician he^^ins hy
combating with the most heroic moans the disnnlejs of his
patients, until he finds that the patients themselves too often
perish in the midst of the conflict. Th(i conii lenci* of inex-
perience is broken down by failure, and th«,' lesson of humility
is taught. He acts less, and watches more; he iinds that Nature
will go on working according to her own hiws, if only he will
leave her alone, llius he becomes "ex])eetant" in his treat-
ment, and watches to learn the various modes ol" working of the.
vis rrvedicatt^: naiurcc. But if he he a true man, he will ikjI
pause here. Man was not made to watch and to oIkjv blind nature,
" vi7icit pareundo," indeed, but vinri/. It is so in every otlier art
based npon science; it must be so in medicine; then Iloma^o-
pathy comes to him, and holds out a law of healing, obtain(*d from
a careful observation of the relation of drug-action to disease.
Acting upon this law, drugs become to him the instruments
whereby in this, as in every other art, man asserts his mastery
over nature. This is the history of the progi-ess of many a
mind; it is the road by which I myself travelled to my present
sure standing-ground in Homoeopathy.
Dr. Russell said that he could not"^ refrain from expressing the
satisfaction which we all felt at once again addressing the Presi-
dent in the chair. He (the President) had said that it was now
8*
1 lit Dr. Uztfn/u un the Positice Services
aliiKxi twrnty yoars sinro lie had first presided. For his (Dr.
Ii*ussrir> part hi* saw no reason why he (the President) should
iii.t .M'.ujiy his |»n'si*nt ]»ost for t lie next twenty years. In regard
to ihf ]»MjH.T just read, he agreeil with much tliat had fallen from
1 )r. 1 1 ii-hfs, who indeed had anticipated what he (Dr. Eussell) had
iiitriidfil to have saiil, and made it unnecessar}' for him to tres-
]»ass n]»on the time of the Society. He would make but one
observation, and it was this, if we accept the conclusion of the
new seimol, as represented hy Dr. llennett, then we must come to
the painful conclusion that as Humoeox>athy has done no positive
gnod, the smaller mortality its results display in acute diseases is
entirely owing to the positive harm of allopathic practice — ^that
allopathy is a great deal worse than nothing. But if this be so,
tlH;n the various systems that go under that name, and which
followed each other in such rapid succession, each new one sub-
verting its predecessor, can have no claim to our allegiance on the
ground of authority from age. The practice of medicine as
]nn'sued hy the expectant school may be good or bad, but it cannot
claim any authority from its greater antiquity to its self-assumed
title (»f legitimate medicine. It is as much a usurper of the
sceptre of Galen as Homoeopathy, or even more so. Homoeopathy
is, in fact, a much older and more tried system than the allopathy
of to-day, which dates from some ten years back. In proof of
this position, he (Dr. Piussell) would refer to the modem opinions
in regard to bleeding in apoplexy. If for any one particular mode
of treatment there was an unbroken accumulation of medical
testimony from the time of Galen to that of Abercromby, it was
that blood-letting was to be resorted to in cases of congestion of
the brain and sanguineous apoplexy. Yet what does a very able
and eminent practitioner of the present day — one of the orna-
meaits of the many ornaments of our profession — ^Dr. Radclifife
— say upon this subject ? He (Dr. Eussell) begged to read a
short passage from Dr. Kadcliffe's work on Congestion of the
l>rain and Ai)Oi)lexy as one out of numerous illustrations he might
have scilected : — " Nay, it may even be a question whether blood-
letting hi\s any advantages at all. No doubt there is enough of
authority in favour of the lancet, but is there enough of reason? Is
tlui theory sound ? Is the practice sufficiently encouraging ? These
are questions Avhich will be answered differently by different per-
sons, and while many will answer unhesitatingly in the affirmative,
others will have doubts which will be expressed in acts if not in
words. If asked, indeed, they may perhaps deny the existence
of their doubts, or speak as if they had none; but in actual
practice, the lancet will scarcely be taken out of its case. A great
change indexed has already taken place, and what the end will be
it is diflicult to say. In the meantime it would seem to be better
of the School of Hoh n tm ann. 117
to err on tlie side of doing too little than on that of dniujr tm*
much; and on this account, for njy own ]»art, I liave alwav.s
dispensed with the lancet, or any mode of liluod-luttin;,', in casi-s
of congestion of the bmin or apoplexy. I liave done this without
what may seem to be good i-eason ; indeed, I should find it
difficult to cite any reason, unless such may he found in the
change which has come over the habits of sncii-ty and the doc-
trines of the scliools. The habits of society are far more t»'ni-
perate than they were foiinerly, and the ])eojil--*, in consri^U'iic**,
would seem to have become less idethoric and less ti>lrrant of
blood-letting. At any rate, plethora is not a comnn^n cliaracter-
istic of patients now-a-days. The doctrines of the schools are
also changed or changing in one most important point. Fornnrly,
every disease was refeiTcd to inflammation, and the pathoh»^nst
was unhappy if he did not discover the traces of this lesion alter
death ; now, many diseases are refeiTed to th(j jirocess which is
the very reverse of inflammation, — degenemtio.i, — and, instc:i I of
bleeding, it has been found to be desirable to enricli the bIt)od
and promote nutrition. Nay, the idea of inflammation its-lf
would seem to be undergomg a change Ijy which it is beconuMg
less fiery or inflammatory, and more akin to the i»rocess wijich
has just been named. At any rate, I have not been able to bring
my mind to order bleeding in any of these cases ; and, so far as
I am able to form an opinion upon the practice which has fallen
to my share up to this time, I have never had occasion to sui)|>o>:e
that abetter result would have been brought about by a dillur: iit
line of practice." This is certainly a remarkable statement, (ind
one which shows how gi'eat a change has taken place in so-called
orthodoxy. To return to Dr. Ozanne's paper, he (Dr. liussell)
considered it a most striking statistical analysis, and one well cal-
culated to excite the attention of all candid minds, and he trusted
that the learned author would more frequently employ his i>en
than he had done of late.
Dr. Chapman was glad that Dr. Ozanne had contriLuted a
paper, though it was brief, and more suitable for the reading
with the eye than for the hearing with the ear. Our dis-
tinguished colleague excelled in many ways : he was a man of
learning and science, and withal an excellent practitioner ; we
had no worthier nor better man in our body. Dr. Ozanne had
been a very diligent student, and for years, in one of the vciy
best, if not the best, medical schools in the world — that of Paris.
He there acquired his taste for statistical science, of which he is
now a master. He pubhshcd in the Homoeopathic Times some
admirable papers, in which he minutely analysed the facts of
medical practice in some of the most important diseases of the
kind called acute. As a man learned in the theories of medi-
lis l)r. Ozanttc un the Positive Services
(•iiM-. ln' ji]ipr('ciatt'3 the vast learning, as a philosopher, the
snl»liiin' ]»hilnsn|)hy, and as a practical man, the admirable
tlH'r;i|M'Utirs <)!' I lahn«'ijiann. He was about the last man to
assirt that the; IJaconian or ///^/^^r/ar pi lilosophy was exploded,
or tliJit iviiablo statistius were without value. He (Dr. Chapman)
cfjii^idiicl iliat it was far easier to treat acute disease than chroniCy
acconliii^r tn tlic law and doctrine of Hahnemann. He hoped
Dr. Ozaiiiie would ])ublish in a se])arate fonn his valuable col-
l»Mtifm of statistics, showing the superiority of the homcjeopathic
iinthod to all (jthci-s in the way of drug-healing. Till he
adopt rl ironi(eo])athy in the year 18-41, through the instrumen-
tality ni Dr. Partridge, he (Dr. Chapman) was a thorough sceptic
as to drug tr(.*atment. He belie veil in surgery, but not in medi-
cine. He had long siniMi anived at the conclusion, so far as
(h'ug-healiiig is eonctTiied, it must be Homoeopathy or nothing.
Our President, in his Annual Address, had given us his ad-
•jnirable ntitone of what has been done during the session about
to (jlosc!. When he is able to come among us, he makes us feel
how (i(jnspicuous he is on account of his involuntary absence.
Dr. CuKr.MKLL, after heartily concurring in the eulogistic
remarks made by Dr. Chapman, observed that, at this late hour,
it would not be fair to detain the members of this Society with
lengthy details of eases in practical illustration of the subject of
Dr. Ozanne's pai)er. Such cases occurred by hundreds in the
])racti((». (jf eacli individual member. He woiild, however, claim
the indulgence of the Society for a concise narration of two cases
(each in its own way) of a character so exceptional as to merit a
])ul)lic record. The first he would instance as a most significant
testimony to tlui rationality of the very hnite creation on the
subj(M;t of lioma'0])athic therapeutics. He w^ould, in fact, tell
them what a cat thought of the homoeopathic treatment of
pneumonia, and how eloquently this "so-called'' irratio7tal
creature (albcjit it S])okc not) bad expressed its conviction of the
ellicacy of honueo])athic remedies in serious acute inflammation.
The second case, or rather terrible cluster of cases — "che nell
pensier rinuiova la paura" — of which one of his own children
AN' as the subject, he woidd mention as an instance of recovery
wJiieh lie bel i(.'-ved to be witliout parallel in the records of medicine,
evcMi sinec^ the days of Hahnemann. Some ten or twelve years
a;4() (1 )r. Chepmell continued) he was in the habit of running out
of town from the Saturday afternoon to the Monday morning, and
(Mijoying tlie fresh air and change of scene at the country-house
of a friend, w^henever his professional engagements admitted of a
little relaxation. On the occasion of one of tbese visits, almost
the lirst wonis which fell upon his ear were the following,
of the Hchool of Uahiununin, 1 ID
addressed by his host, General , to a fieiviiiit : — " J(»h?i, you
had better shoot the cat, and put tho j)0(»r brute out of it.^
misery." The subject of this order, a favouriti* liouso-cat of tin*
family, lay at full length on a mat in a conna* of tin: i-oom,
gasping and struggling for breath, to all a])i)eaninct' fast apiu-oacli-
ing to the term of its "nine lives." It had rt'niained for scvi-ral
days in this position, if'fusing to (juit tlu^ spot or to tiikt/ food of
any kind A reprieve was cheerfully grautt-d, on Dr. CIh'Ihu ll's
volunteering to ascertain whether a less heroic method of tr*at-
meut might not be pureued to the advantage of all pailies. ( )u
making an examination of the chest from its dorsid asi)'(t,
extensive dulness was elicit(?d on jiercussion, on bt)th sidi-s, in a
nearly equal degree; the vesicular breathing was inaudiijje; and
the loud hissing tubular ronchiy neJir the base (»f the saxpalrr on
either side, were singularly marked. In fact, there were the
Tinmistakeable physical evidences of a very serious case of double
pne^cmonia, which had gone on unchecked, and was fast ])roceed-
ing to a fatal issue. Six drops of Phoqyhorus, :3rd dilution, weixi
forthwith dissolved in six dessei't-s[)OonfuLs of cold water, an I a
tea-spoonful of the solution prescribed to be administered e\-ery
hour. Owing to the patient's natural prejudice against cold
water per se, the admixture of a small poition of milk was at
first thought of; but as it had already refused even lic^uid food,
this plan had to be abandoned : consequently, lh(^ administration
of the remedy presented a serious diiiiculty. In this dilemma it
occurred to Dr. Chepmell that advantage might be taken of the
animal's counter-prejudice for cleanliness andcomfoit: accord-
ingly, the dose was regularly dropped upon its coat, and as regu-
larly licked up by the patient : — at first, with a view to getting
rid of the physical discomfort; afterwards (as the sc^qucl of tlui
case will prove), from a well-grounded conviction of the remiidial
virtue of the spilt fluid. No sooner had a cou])le of doses be(»u
thus imbibed than a marked and steady cliangci for the better
took place; and, after each successive repcitition of the remiuly,
the oppression of the chest bcjcame less and less intense, so that
by midnight the danger of suffocation scjcanod no longer immi-
nent During the remainder of the night a member of the
Greneral's household, who had taken a great interest in the cas",
continued the administration of the medicine at intervals of
about two or three hours. Throughout the next day (Sunday)
the .improvement continued; the cough was loos(.'r, and the
breathing less laboured; the animal lu^gan to take li([ui(l food
in the shape of mUk and water, and to move about a little,
although still, for the most part, a fixture to its mat. A cor-
responding improvement had taken j)lace in the physical signs ;
for, although the dulness on percussion was still extensive, the
120 Dr, Ozannc on the Positive SerHccs
intensity of the tuluilar lircatliing had much diminished, and
soil ciTjiitiint I'alrs ^Vl•lv audible at the extremities of both lungs.
I'lidcr tlu'st' fsivnurabli' circunistanoes, tlie intervals between the
dnsi's wen* prolon^^i'd to three and four hours during the day, and
ii(» niiMlicinr was oxliibited from midnight until the next day. By
!M(»uday morning, a fui-tlirr and marked improvement had taken
]»lac('. Tliii animal was beginning to move about more briskly,
anil had i»artaken of bread and milk. On taking leave of the
family, Dr. ClieinnoU left a supply of P/w&^t?)^^?'//^, with instruc-
tions tor its eontinued exhi]»ition, until his return on the follow-
ing Saturday afternoon. On renewing his visit (on the Saturday)
liL leiirned from his host that his feline friend had, for the two
previous days, been roaming about the garden, engaged in its
favourite i)ursuit of watching the spaiTOWS, and from that time
had "voluntarily given up the treatment." On asking for an
explanation of what he mi»ant by the expression " voluntarily
giving up tlut treatment," the General assured Dr. Chepmell that
h(^ was not using the phras(»- in a rhetorical sense, and instanced
as a proof of the oat's wonderful rationality on the subject, the fact
that, in the course of the i)revious Monday, the young lady who
had been in the habit of administering the remedy in the manner
already mentioned, having forgotten her charge, the animal of
its own accord caine, and, by the pecidiar way in which it
attracted attention, contrived to remind her of the omission.
Thereupon, it occurred to her, that she would test pussy's real
intentions by presenting her with a spoonful of the remedial
so 1 11 1 i on. The cat, withcnit the slightest hesitation, at once lapped
up the medicine from the spoon, and then returned to its mat.
From that time forward until the day when it " voluntarily gave
up the treatment," as no longer applicable to a state of health,
the cat having become its own physician, would come of its own
accord, as if by a tacit agreement (at first, at intervals of four
or five ; then, as convalescence advanced, of six or seven
hours), and diink the medicine out of the spoon from the hand
of its fair mistress, so superior had the feline mind risen to tlie
prejudices of mere physical instinct. Before quitting liis hos-
pitable friends. Dr. Chepmell had an opportunity of ascertaining
the completeness of the cure by a physical examination, to
which his former patient, who was, in truth, a very gentle and
tame ci-eature, subnntted with becoming grace. With regard
to the second case (that of his own child), Dr. Chepmell
remarked that, although his nerve had never failed him in so
far as the treatment was concerned, he had at the time no
heart for scientifically recording all its frightful complications.
In fact, during u])wards of six months of agonising suspense,
he hardly dared to believe in the possibility of a favourable
(if tlvt School of HahmmtiniL 121
issue, with such fearful rapidity had each Ruccossivc* hlnw
been struck, hefore the cumuhitivu Kluuks cif ])nMMMliii<r attarks
could be recovei'cd from l»y the sluiltcnMl ci»nsiituti«iii nl' tin-
little patient. He would, luiwovrr, j^ivt.* a suiiiniarv of this
great triumph of the healinf:r art, wliith In* Ih-Ui'VimI to U^
without a parallel in the annals nt* iinMlirinr, and l'«»r w liiili
he would ever be grateful to the nu'iiiur}* nf that ^'icat ami "loiid
man, whose genius lighted fur all tinu- that tlu-raiM'Utic InMi-on
by which, in the darkest night of ]»at]i<ilc»gical uncertainty, the
foundering vessel of mortal life may yet be stifi-ed intu the
calm channels of convalescenee. About the bi-ginnin^ nf l-'t-hniary
1861, his daughter, then a imiviously ln-althy chiM i»f r» yrars of
age, had an attack of continued fever, which, almost from the
first, assumed a ty|.)hoid form, and which, having seriously en-
dangered her life, left her, after a duration of between >ix and
seven weeks, in al>out as unfavourable a eomliiiMn as mnld
well be imagined for a struggle with any fresh niorbitic inlluenco,
a very wreck of herself, weak and emaciated to a d«'^M"e(.* that
would have rendered him anxious for the fulun*, had no n« w
complication ensued. As a measure of llie virulenct; of the fi.vcr,
he might instance the hideous disfigurement of the u]»|)(r lip
(which continued for many months, an<l of which slight ciea-
trices remain to this day), caused by several extensive fissures
right through the skin and mucous membrane, consequent ui»on
the excessive haemon*hagic exudations of the mouth and nostrils,
at which the child was constantly picking, when the ty]ihoid
symptoms were at the worst; he might also add the occasional
suppression of the urine, the troublesome b(?d-sores, and the
tendency to colliquative diarrhoea, to say nothing of that disposi-
tion to congestive bronchial cataiTh which afterwards became so
formidable an element of futm'e danger. In so unsatisfactory
a manner had convalescence commenced that it occurretl to 1 )r.
Chepmell, who at the time was attending a case of measles, that
an attack of this exanthem was only wanting to insure a I'atal
issue. Within a few days of this unwelcome thought, the eru])-
tion of measles, ushered in by fever and delirium, mac hi its
appearance. The eruption, which at first was very full and
confluent, suddenly struck in on the second day its retrocession
being immediately followed by symptoms of cerel')ral and pul-
monary congestion, with coldness of the extremities. After the
timely exhibition of Cuprum Aceticum and BciUadonna at short
intervals, the eruption again reappeared, althougli in a less
satisfactory manner, and simultaneously a suppurative inilamma-
tion of the eyelids (which for ten days effectually blinded the
patient) completely relieved the brain, and in a less degree the
lungs. The exanthem continued to run its course imchecked.
122 Dr. Ozanne on ttte Positive Services
and had no sooner faded away than the smouldering mischief]
the dutat hurst into a flame, and acute Broncho-pneumonia, e:
tcn.siv(;ly aifecting hoth lungs, in about an equal degree (in whic
the phniritic membranes became ulthnately involved), ensue*
0\vin;j[ to the ])rostration of tlie vital powers, only a partial r<
covcry luul taken place and a tlireateiiing state of sub-acu1
iiiflannnation had remained behind, when, at the end of anotlu
fortniglit, by way of climax, the symptoms of whooping-coug
werii su])eradded. From a once comely child she was now r<
duc(3d to a mere living skeleton, a tmly hideous and pitiabl
oljjcct to behold, as though she had put on the withered feature
of decrepit old age. The moral irritability which accompanie
this ])hysical dilapidation was not less distressing to witnesi
Notwithstanding the frightful struggles with the wliooping-cougl
attended as they often were with imminent danger of suffocatioj
re])eated day by day and night after night, and the frequer
rekindling of the acute Broncho-pneiunonic inflammation, on th
sliglitest unfavoumble atmospheric change, during that tryin
spring of 18G1, she had rallied sufficiently by the beginning c
June to justify the risk of her careful removal to the country
at a short distance from town. Evfm then, he himself had bu
slender ho])e — ^whilst those of Ids intimate medical friends wh
had watched the case, as they afterwards confessed, had eve:
less — of lier idtimate recovery ; for there was still a considei
able amount of condensation of the pulmonary parenchym
on both sides; much sub-acute bronchial irritation in bot
liuigs, and more or less serous effusion in both cavities, moi
especially in the left : moreover, the emaciation had not bee
recovered from, she was worn out by hectic fever, and unabl
to stand from weakness. Under the reviving influence of th
pure mild atmosphere of Forest Hill and Sydenham (for she W8
regularly carrietl out into the open air on fine sunny days), sh
rallied slowly yet steadily, regained her appetite, and the ches
affection became less urgent ; so that by the beginning <
8e])t(Mnl)('r, when a change to the sea-side was thought desirabl
she had gained a little flesh and was able, with assistanc<
to walk a short distance. After going back to town for
week, she was taken to Guernsey, where she remained unt
the end of October. During her stay, she was under the imme
diate care of her talented uncle. Dr. Ozanne, who successfull
brought her through two serious relapses of acute Bronchc
pncjumonia. Although, on her return to London, the aifectio
of the lungs was still very serious, some ground had been gaine
by her rijsidence in Guernsey. Tlie whooping-cough was le*
troubh^sonie, and she had i)icked up a little more flesh. Durin
the winter of 1861 to 1862, the improvement was remarkabl
of th€ Sf'hool ttf II, I h I}, f„ ,1 „/,. \ -j; ;
steady; and, iiotwith.staii(liii*( tMrasimial ilin-at.-niiiL'^ «.!' nn. u.-i
pulmonic conf;f\stion, tlirn* \vi*r«» in) sfrimis rila|i-i-^. Th,. , |,ii,|
was, of necessity, almost entirely cnn tin i« I tn tht- limi-.-. takiiii»
an airing in the curria^^n* cm «'xi«-|»tiiiiial»ly lim- (Ia\-. \\\ ih..
end of the winter, however, tin* litll*- |«ali«iil liail r.LMiiJ««l in a
measure her ijlumimcss and ^^ood l«M.k>: tli** liniL:> w.-n- nnr,.
more iXTvious to the air; tin* hertir li-vi-r had r.-.i-^.-d ; an>l all
that remamed of tin* fnrniiilahli' array ^\)i clu-.! >\ inpioni- \\a-< a
clmmic bi-onchial ratarrli, ehi«*lly eniiiin»d In tli" i-li liniLr. and
from which the rij^ht was eoniiiarativcly Iiim-. niirin;: lii" -|"ii!ij.
and summer of 18(3:i sin* was alil«' tn tak'- a lair aiiiMiin! ni
walking exei^cise on every fine day; and. wiili tin- i\. . |.ii..ii mI
one or two ]')an)xysnis on first ;4"ttin^' into lu-d at ni-hi an-l nn
awaking in the morninjr, the cough did not ironlilf ler Inr day^
together: her a])[)elite was excellent, an«l ln-r ^'-n'ral ln-al!li ni«»'t
satisfactor}\ On her return to (luernsiy in lIi-- aulunm. Dr.
Ozanne was struck with aniazenn-nt at tin* evid»'nr»-s uf li.-i
recovery; for, when ho had taken leave nf Inr tin.* yi-ar iM-tni-.-,
he scarcely believed the resolutifjn ol' so mmli or;:ani«.' misc-hii.t
in the lungs possible to a constitution so sliatl«ivd. II.- tii.-n
thought that she had only survived that inmnMise ani<»mii of
acute disease, eventually to become the victim of ]iuhii«»nary
consumption. A residence of some months on that iMautiluI
TAncresse Common, where she daily took an amount of ex.Mvis** to
whichmanyan adult wouM have lK,'en unequal, so coiii|iht»ly re-
stored her, that from that time all anxi<'ty eeasiMl on In-r aee.nint.
He might add, that, at the close of that same autumn, <linrily
after she reached honn», she had an attack of srarlaiin:i. fmni
which she recovered most satisfactorily, lie would now ;^ivi' an
abstract of the reuKMlial treatment pursuiMl with su<'h a liajij)y
result. The ty])hoid f(»ver was chi(?fly treated with Aeonit., iiry..
Khus Tox. Cantliaris., r»eHad., rhos])h., IMiosj»h. Acid., Arsen. and
Sulph.;themeasles,withAcou.,rulsat.,(Jupr. Acet., r>ella<l.,Pho<j»li.,
Bry. and Suljdi. ; the pneumonic inllammaticui and it-; nunn rous
relapses, with Aeonit., Thosph., Tai-t. Kmet., and Sulph. ; the
whooping-cough, with I>ellad., I])ecac., He}). Sul])h.,and (.'arb. An. ;
and the scarlatina with BellaiL AVith the exce])tion of Siilph.,
Arsen., and Carl). An., which were also exhil)ited from time to
time in the 30th and 20Utli attenuations, when there was exces-
sive prostration of the vital powers, and of riK»si)h., Tart. Emet.,
Sulpli., and Aeonit, which were also administered in the I»rd,
4tli, and 5tli decimal attenuations, whiMi i\\it inllammatit»nsof thii
lungs were very acute, the 3rd cent(^sinlal or <)th decimal were.
the attenuations prescribed. To rhosi»h. and Tart. Kmetic, abov«;
all the other remedies (which, nevertludess, fully answered their
124 Dr, Ozanne on tJie Positive Servicer
respoctivc imlications), and to single closes of 1 or 2 drops of
»SuIi)h. 30tli or 200th, did the patient owe her life over and over
agiiin, when Dr. Chepmell thought that she could not outlive the
night, whotlier from the intensity of the relapses of acute inflam-
mation or from the consequent vital prostration. So great was the
chikl's own appreciation of tlie action of these remedies, that she
would lierself imerringly suggest their exhibition (aft<3r she had
got to know their names) from her own feelings. A diet gradually
proportioned to the powers of assimilation, a cautious use of
dietetic stimidants (which at no time exceeded 6 teaspoonfuls of
})ort wine, and 2 claret-glasses of Dublin stout, in the twenty-four
hours), a teaspoonful of Cod Liver Oil (as soon as the stomach
couhl boar it), and cliange of air, especially at the sea-side, were
restorative elements of the highest importance.
The Pkesidext, in summing up, remarked, that the paper
read to-night Avas highly interesting and important, and quite
bore out and justified the remark made by him in an earlier
part of the evening, in his acUlress from the chair, that a
paper l)y Dr. Ozamie Avould be sure to be replete with practical
information, and give evidence of careful investigation. The
author had already established his reputation as an accurate
collector and lucid arranger of statistical facts, which, when they
were honestly dealt with and conscientiously recorded, must
always carry great weight of evidence to all inquiring and
earnest minds. He agreed with Mr. Yeldliam in his observa-
tions about acute diseases, and, indeed, all experienced homoeo-
pathic i^ractitioners were unanimous in their opinion as to our
mode of treatment being much more successful in acute diseases
than in chronic, and that if they wished to carry conviction into
the mind of an enlightened and experienced physician of the
prevailing school, they would much prefer showing him their
treatment of acutely inflammatory cases than those of a less
urgent nature and acute character; and if the inquirer came
with an earnest desire to seek the truth, and brought a mind
unbiassed to the investigation, he coidd not fail to perceive the
power of Homoeopathy to combat acute disease in its various
forms. He (Dr. Quin) also agreed with Mr. Yeldham respecting
the greater difficulty attending the treatment of chronic diseases,
if it were wished to impress our opponents of the old school
favourably with respect to the advantages of Homoeopathy ; but
even here, if the inquirer carried on his researches patiently and
in good faith, he would find that he had entered on a wide field,
in which means were at his disposal to treat successfully many
cases which had previously baffled his attempts to cure by the
ordinary method. In both schools, it was universally acknow-
ledged, that chronic diseases were more difficult to cure than
of the School of Hahneviann, l25
acute; but wheu an allopathic physician saw the siiccoss-
fiil treatment of several severe and well-niarkcHl chronic cases hy
Homoeopathy, it had a greater efTect often upon him than the cure
of a similar number of acute cases, because he had gi-eater dilU-
culty in the former than in the latter, to attribute them to a
spontaneous solution- He (Dr. Quiii) was inclineil to go with
Dr. Hughes to a certain extent in his strictures on the utility
of some statistics in proving the superiority of one system of
treatment over the other, unless the circumstances under which
both treatments were carried on were exactly identical, and the
cases similar in gravity ; but these objections fall to the gromid
when the statistics were gathered from the Hospital practice of
a physician like Dr. Tessier, who compared the results of his
own ti-eatment in his own wards under the two different modes
of treatment — ^the old and the new ; and let it be bonie in mind
that, at the time of his experiments, he was a most skilful,
accomplished, and experienced physician in the mode of ti-eat-
ment of the old school, whilst he was but a recent convert to,
and inexperienced in, homoeopathic practica Similar value
attached itself to the statistics of his (Dr. Quin's) friends, the
late Dr. Mabit, Professor of Pathology and Physician to the
Hotel Dieu, Bordeaux, and the late Dr. de Horatiis, Professor
of the University of Naples, and Physician-in-chief to the
Military Hospital, both of whom had published the results of
their experiments in both their respective hospitals, in the treat-
ment of acute cases under both systems. For the same reason
the results of the treatment of many acute cases recorded by
Professor Henderson, of Edinburgh, former Physician and Clini-
cal Professor to the Eoyal Infirmary, were of the greatest interest.
In aU these instances and in others, which he could quote were
it necessary, it was not sought to pit the results of the treatment
of one physician against those of the treatment of another, nor of
one Hospital against those of another, but of the new mode of
treatment against that of the old in the hands of the same phy-
sicians. Here there can be entertained no suspicion of a wish to
triumph over an opponent or a rival Institution, nor a temptation to
falsify the results. He (Dr. Quin) fully agreed with the foregoing
speakers in regarding the Expectant School as the stepping-stone
to Homoeopathy ; and when one compared the mode of treatment
practised by allopaths some years ago, with that pursued by them
at the present day, there could be little doubt that it tended
more and more towards Expectancy, which he looked upon as the
high road to Homoeopathy. At one of the Society's meetings many
years ago, when the debate took a similar course to that which
it had done to-night, he had referred to an anecdote told of an old
£riend of his, a distinguished physician and Military Surgeon-in-
chief of the Austrian Army in Bohemia, Dr. MahrenzeUer^ "wIlo^
I 2C) Dr. Oxaiinr on the Positive Sa^vices
^vll('Tl lie first made his acquaintance, practised at Prague. As
the anecdote bore upon the point touched upon by several of the
speakers this evening, he trusted they would not think it irrele-
vant his again relating it : — ** Dr. Mahrenzeller having passed most
of his nunlieal career in the Anny, and in great Military Hospi-
tals, was, what was held in the highest esteem some years ago in
England, and denominated, an active practitioner, one dealing in
heroic remedies, in large doses, copious bleedings — in short, in
violent medicines, both internal and external. When the head-
quai'ters of the Division of the Army to which he was attached
was stationed at Prague, he Avas, from the high position which he
held, much consulted ]>y the townspeople of the wealthier class,
and his ])ractice extended itself greatly among the civil as well
as the military ; so much so, that few cases of danger occurred in
which his advice was not sought. It w^ould seem that the mili-
tary medical practice, which he introduced into civil life, had
an}i:hing but a favourable issue in the majority of his cases ; so
much so, that the churchyard became rather densely peopled,
and w\as known under the name of Mahrenzeller's Garden. His
reputation naturally suffered, and his practice gradually dwindled
aAvay. Shocked and horrified at these melancholy results of his
heroic mode of treatment, he became disgusted with it and
himself, and resolved to see w^hat would be the result of leaving
Nature to herself. This he commenced doing in his hospital, and
his practice was so much less fatal, that he gradually introduced
it into his private practice, and he confined his prescriptions to
bread pills, an occasional mild aperient and diluents. About this
time the General-in-Chief of the Army, Prince Schwartzenburg,
w^ho had long been suffering from a painful disorder, from which
he could obtain little or no relief from the usual means, resolved
upon consulting Hahnemann, at that time rising into fame, as
the founder of a new system of medicine. He left Prague accom-
l)anied by Dr. Mahrenzeller for that purpose. The beneficial
results attendant upon Hahnemann's advice were such as to
induce Mahrenzeller to consult him upon a disease from which
he had himself been suffering for some time. The benefit
was so marked, that, already in some measure prepared by
his disappointment at his old mode of practice, and at the less
unfavourable results of the Expectant, he resolved to study
Homneopathy, and finally became one of the most distinguished
homoeopathic physicians in Germany, first at Prague, and then at
Vienna, w^here his success greatly tended to the spread of the new
system. It was to him that was entrusted the homoeopathic ex-
periments ordered by the Emperor, to be made in the great
Allopathic Military Hospital at Vienna — the Joseph's Academy
Hospital — ^which experiments were so successfiil,that they resulted
in the conversion of one of the Commissioners appointed by the
of thi' SfhiHtl t'f Iluhmnnrini, y2.1
Government to watch and rop<»rt iip(»n tln'in,— Pn»i'i'ssnr /Inra-
to-witz. Dr. Mahrenzoller liad in liis own Military Hns]iital. at
l*rague, full oppoilnnity of watiliiii^' and tlicidin^' n|H»n tin*
respective merits and advantayt's of tin* tlnv<' nn'tlmds nt* In-at-
ment inaxiute diseases, ])ractised by liinisi'lf, at tlin'ctiiirm'nl pe-
riods— ^the AUopatliic, the Expectant, an«l the. iromn-oimthic — and
the statistics obtained by each mode caused liini t«» <leride upon
the latter as infinitely the .su])('nor." With rfsjH'ct to the obsrr-
vations of Dr. liussell, concerninf^ the threat revdbition which has
taken place of late years in tlie use of the lanci't in inllaniuiatiny
diseases, and more especially in a])o]»lexy, and to tlie interrstin^
quotation from Dr. iiadclifle's work (ju ('nu<:« -st ion of the Uraiii
and Apoplexy, in which the important aihnission was made on tlie
inutility, nay harm of bloedin*:; in a])0])lexy, he (Dr. Quiuj recol-
lected the time when the medical man who abstract«Ml the;
greatest quantity of blood was looked up to as a hero and a most
skilfid practitioner, whose footsto])S ought to b(» ibllowe<l and
imitated ; and even after mc^n began to (lou])t the* ])ropriety of
the practice, and see the danger of using such large depletions,
such was the force of example and custom, and such the* tyranny
of authority, that practitioners resoited often to bleeding, in spite
of their better judgment, to shelter themselves from the blame
and obloquy that they were sure to incur, if, on being first call(»d
to a patient, they neglected co]>ious venesection. It Avas on th(^
Continent that this salutar}' revoluticm first commenced, lie (Dr.
Quin) remembered, as far back as 1829, a circumstance which he
had mentioned in a former debate (in 1846) just after the deide-
tory system introduced by Broussais began to lose caste and
show its baneful effects, so as even to stagger the author of the
physiological system of treatment, Broussais himself, that Fou-
quier, the Physician to the Salpetri^re Hospital in Pans, with
whom he (Dr. Quin) had several consultations at that time,
Fouquier being a great authority in diseases of congestion anti
inflammation, — in fact, in all diseases connected with the
vascular system, — acknowledged that he believed blood-letting
in apoplexy to be not only of no avail, but positively inju-
rious. He had put it to the test in the' wards of his
hospital in the following manner : — The Salpetriere had more
cases of apoplexy and epilepsy than the other hospitals of Paris,
and a number of the cases occurred in old veterans. All the
cases that came into the hospital on Mondays, AVednesdays, and
Fridays, were put into one ward, and aU those that came in on
the alternate days were put into another ward ; and Fouquier
ordered the patients of one ward to be treated according to the
usual mode hitherto pursued in the Hospital, viz. by venesec-
tion, cupping, leeching, and other antiphlogistic means, whilst
the inmates of the other ward were none of them bled or reduced
1 28 Dr. Rartfiford on sortie Affections of the Knee-Joint,
by other depletory means, but rather sustained and slightly nou-
rish(^d : tlu* result was, that he lost considerably fewer patients
in the latter ward than in the former. The experiments ex-
tended over several weeks, and ended in Fouquier abandoning
the practice of blood-letting in such cases. Here, again, we have
the statistics in the same hospital, under the direction of the
same ])hysician, treating similar cases by two different modes,
proving in favour of the one mode over the other, in a manner
wliich cannot be considered open to suspicion. He (Dr. Quin)
heartily concurred in the eulogy passed by Dr. Chapman, who
was always generously alive to the merits of his colleagues, and
ready to record in his speeches his favourable opinion of their
labours. The past and present labours of the author were most
important and praiseworthy ; and he earnestly hoped that Dr.
Ozaune woidd continue to give to the Society the results of his
research and experience. The evidence brought by Dr. Chep-
mell in practical illustration of the paper of his relative, Dr.
Ozanne, was well worthy of their attention, particularly the for-
midable and complicated case of his little daughter, of which he
had given the most minute, circumstantial, and interesting
details. The history was a harrowing one, and they must aU
feel the deepest sympathy for the father who witnessed in a
beloved cliild such a succession of violent diseases occurring
with such rapidity, and he (Dr. Quin) heartily congratulated
him on the fortunate escape of the child from such repeated
imminent periods of danger and its final rescue from the jaws of
death. Such a case as that, so feelingly told by a parent, ought to
carry conviction into the most obstinate opponent of our school,
of the good faith and earnest and conscientious belief of the
narrator in the blessings conferred on us by the great discoveries
of Hahnemann.
ON^ SOME AFFECTIONS OF THE KNEE-JOINT.
By Dr. Eansford.
Upwards of thirty years since, when dresser at the Bristol
Eoyal Infirmaiy, I had under my charge a little girl of stinimous
habit, about seven years of age, who suffered from what was
called a white swelling of the knee-joint. It was a case of
chronic inflammation, originating, probably, in the synovial
membrane, but in which the other textures had become in-
Trivei TLe:^ "ins c:'::::r.'r:-:\l ]«axn. wiili u'n'at onlarufinout ol
tie i::iil "Br]:::!: jres-jiitoi :ho piviiHar whito anjuMiaihT rioiu
vliiL tie iL^ne -wLito swtllini;" is ul'i.iiiuil. Tlu' nmihiii
of llr y-iiLZ •«"« VvT}* l::r.:Ti\l : ^xti n^inn «'f tin* liinl* rouiil imt
l»r ror^r: ::.5 iisu.i! }'.'<:::"ii >va> ilif Iialf-luut tiiif; !h.« ]i.ilirri!
W-^iTT.-r Lr:::.\ ?!-:-t]'>'.5> : lur luallli was ra|»iil!v f.iiliii;' Sin-
Lad \K-rii :vr.-.i^:-J with looohrs. tartar niuii*'. niiiinii iit, Mi.i-
lirTs. krj't oj«en l-y Sabiiio ci-rato ainl all tin- i»llnr Ih-IiIn |.ii.i.|
appliiincr* cf the Jay. iiiohulinir issui^s anil mMimis. r.irij i.l
vitli drugs of all sons, aiul giwn in all shaju-v Tlw Sm ■.
who weK men of emiiuneo, iIooIiUmI. afiiT fiinsuliali«m. tli.ii tin*
limb must t«e amputatoil. or that tin' rliild \vi»ulil .•.)».■. .IiIn <!h-
This decision was coimnunioatod \o tlu* iimtlii r. w Im wmiM imi •
consent to the operation, and ivnii»\ril Inr cliilil \'vu\\\ tin* luiii
man" to her own eottagi\alu»iit thnv niili's iVum I'li-.d)!. ;hiiiu«
months aftenvards I was in tlu» ni'i«;Ii!MMirliiMMl o\' Iht iiiuiIm i.j
house, and called to inquiiv whi'tluT tlir cliilil wmm lixin;- Tn
my astonishment I found Iior walkin<^ alxuit. in lair Ih-allli. uinl
the afiected limb not very tlilViM-ent iVnm its jrllnw. I w.n
informed that a surgoon, practisinj^ in tin* iicij-jilMHuinMMJ, JKid
done it up verj" caivfully with a variety of plai.lrr.i iimi mni
ments: and by these moans Ihti j^'irl hail ln-ni rmiil 'lint
surgeon (so called, for ho was an imh'ri'ii mmI piaciiiioiK-i i hiul
become familiar with the tivatnu'iil ;uli»plri| liv Mm- lulr Mr
Scott, of Bromley, Kent, and apply iii;.j il. In Hhm rliilij wa.i
rewarded with signal success. Tlu* cnse \v:i;* (uk^ ('.Ml«'iilal.«Ml in
make a lasting impix^ssion upon the iiiiiid of :i .".liidcnl. ui-niik
tomed to consider the oracular sayin^^s and dnin;':j nl lii.i
teachers as decisions from which thrro wjis no jippcal. I did
good to many cases in my pupila^'o u]K)n this prinriph-, :ind
studied with interest Scott's work, entitled "On |ji(> Tr<:ilhniif.
of Diseases of the Joints and of Tlrei-s and Ciirnnic Inilaninm
tion." This work was not favourably niccivr-d hy tlic prof.-.i-
sion. It was severely criticised, and f«)r reasons which may
readily be assigned, his reviewers pronounced Mr. Se.oi|.'M
130 Dr. Ransford on Rome Affections of the Knee- Joint,
pathological principles to contain nothing new, and his plan of
treatment, which was fully detailed, was slighted and dis-
couraged Indeed, the history of this work well illustrates
professional prejudice. It has been correctly observed, " that
altliough an accurate description of diseased states, and the dis-
covery of some phenomena about them not previously recog-
nised, are hailed by the profession, and confer immediate dis-
tinction upon the author or observer ; yet remedies, or plans of
treatment, however effective and valuable, are always received
very coldly, frequently with perfect indifference, and sometimes,
nay often (as the members of this Society can testify), meet
with unsparing and unscrupulous opposition." We could
produce abundant unimpeachable testimony, that John Scott
succeeded in curing numbers of surgical cases which had been
pronounced hopeless by many eminent surgeons of the day.
In fact, he saved for his patients innumerable limbs which had
been condemned to amputation. In the few cases which I
shall have the honour to read this evening, it wiU be seen that
I have ceased to follow Mr. Scott's mode of practice, because
we, the professed disciples of Hahnemann, believe ourselves to
be in possession of a stiU surer guide to the administration and
application of remedial agents, so far as the Materia Medica is
concerned; at the same time, although we were never acquainted
with each other, I should not have considered myself just to
John Scott's memory had I not given my feeble testimony to
his skill. Undeterred by opposition or the severity of his
critics, he continued his practice, and realized by it a large
fortune. He laid considerable stress on giving the affected
joint rest, and applying uniform and gentle pressure to it. In
addition, he bathed the parts with Camphorated Spirits, and
applied Mercurial Ointment with Camphor. In all injuries
and diseases of the joints in the slow strumous degeneration
luhite siveUing (a very vague and comprehensive term), as well
as in the most violent form of articular inJBammation, perfect
repose of the affected joint forms a powerful and effectual
Dr, Hansford on some Affections of the Knee-Joint, 1 81
curative indication. The means described by Mr. Scott per-
fectiy secured the quiescence of the joint; but it does more
than this, — it excites and maintains a gentle warmth and
action upon the skin over a large surface around and con-
tiguous to the diseased joint, and thus, by the well-known
principle of counter-irritation, relieves and subdues the
inflammatory action in the structures of the joint itself;
besides which. Mercury is, to a cei*tain extent, homoeo-
pathic to many of these cases. Sii* Benjamin Brodie's work
gives information respecting the pathology of diseased joints ;
but we believe that Mr. Scott's work gives better instructions
for curing them, so far as Allopathy is concerned. It will not
be disputed that afifections of the joints are a class of diseases
which have strong claims on the attention of practitioners,
since they are of frequent occurrence, are sources of deep
anxiety to the patients, and for the most part, if neglected and
maltreated, proceed to an unfavourable teimination. I venture
to bring forward two or three cases, with the hope that the
suflBciency and superiority of treatment suggested by the
homoeopathic law may be apparent. The first case may
perhaps be termed one of chronic inflammation of the synovial
membrane, arising from constitutional causes, which, as my
audience well knows, are often vague and diverse, and into
which part of the subject too much time would be required for
me to venture upon ; besides which, such a disquisition would
perhaps land us in the regions of hypothesis. The subject of
this case, Henry M , had been an intemperate man ; there
was likewise reason to suspect a sjrphUitic taint. Eheumatic
or gouty symptoms presented themselves, arising probably from
hereditary predisposition, fostered by the patient's habits of
life and exposure to atmospheric changes. He first consulted
me in York on August 28, 1855. His age was 31, unmarried ;
his occnpation groom and valet ; he resided in tlie country,
within six miles of York. He has an enlargement of the
left knee-joint, with great pain, which is worse when he walks ;
9*
1 ;V2 Dr. Ransford on some Affections of the Knee-Joint
and lie described the pain as running down to the ankle and up
to tlie slioiilder. Appetite had.
IIc'[)ar Sulphuris 6 was ordered.
Sept. 3. — The joint is smaller; the pain is less; he feels
hettt^r. Hopar was continued; and a cloth, dipped in a solution
of Hepar, was ordered to be applied as a compress to the joint.
Sept. 22. — Much better. The pain is trifling. The joint
becomes stiff after moving much about. Sulphur was ordered
internally, and externally as a lotion. Unfortunately, about
tliis time he was kicked by a horse on the shin of the aflfected
limb ; the consequence was a contused wound, to which Arnica
cerate was applied with success ; but after the wound healed
ulcers appeared on the leg, which ulcers were obstinate. Calendula
cerate and strapping did some good, but the internal exhibition
and external application of a solution of SiUcea produced more
speedy amendment. The knee-joint was comparatively well,
but the ulcers on the leg were tedious. During the time that
he was under treatment he took Silicea, Hepar Sulphuris, Sul-
phur, Graphites, Belladonna, Arsenicum, and Nux Vomica,
according to indications. He was under my care from August
28tli, 1855, to March 2nd, 1856; after this I neither saw
nor heard of him, because he was able to fulfil his duties as a
servant, until February 16 th, 1857, when he called again upon
me on account of the appearance of fresh ulcers in the same
leg : these healed in a month under the use of Silicea, applied
externally, and taken internally. Fortunately for my patient,
he did not adopt the recommendation of an hospital surgeon of
eminence, who, previous to his first application to me, had tried
upon him the usual orthodox remedies, and concluded by
recommending amputation of the aflfected limb.
The details of the next case were sent to me by a clergy-
man in the north of Ireland, with a request for my opinion
and advice. I prescribed the external application of Arnica :
the result was most gratifying. T read, without alteration, the
account as sent to me in October, 1860 : —
Dr. Ransford on some Affectiom of the Knee- Joint, 133
"Elizabeth M'Kenn, aged 19, suffered for several months
from a swelling in the knee. The pain was excruciating, and
the leg was greatly inflamed, and swollen to double the natural
size. Several doctors were consulted — I believe six altogether.
One recommended 'warm poultices, to cause suppuration;*
another, scarifyiug and blistering; another said that 'imme-
diate amputation was the only way to save her life;* another
said the disease was 'Elephantiasis.' She suffered intense
pain, could make no use of the swollen limb, and got no sleep
for a long time. I visited her under these circumstances as a
clergyman, and by the advice of a physician practising lioma^o-
pathically, recommended a trial of Arnica. I accordingly gave
some Arnica, with directions to bathe the knee witli warm
water, and then apply the lotion, rubbing it for some time
gently with the hand, and then apply well-saturated linen cloths,
covering all with oiled silk; the applications to be renewed
every half-hour. In about two hours a very copious eruption
of watery pustules appeared, and the pain was greatly abated-
The applications were continued more than a week, but there
was no eruption after the first two days. The swelling gradu-
ally fell, and the pain altogether left the knee-joint, wliich
seemed to have been the original seat, and settled about half
way down the leg, where the patient felt what she described
as ' a drop of water running up and down the inner side of the
shin bone.' The spot where the pain settled was touched with
a lancet, and suppurated, and has remained an open sore about
as large as a fourpenny piece, with a very slight occasional
discharge at intervals ever since. In other respects the girl is
quite well. The duration of treatment with Arnica was six
weeks ; it is now about eight months since the lotion was first
applied. The lotion used was from 6 to 8 drops of the
Mother Tincture of Arnica in a wine-glassful of water, a fresh
mixture being made every time the linen was saturated. She
was very weak for some time, I believe, from the intense
sufifering. A doctor says it arose from the dangerous Tiature of
tiU lotion used. The girl continues well."
134 Dr. Hansford on some Affections of the Knee-JoirU.
A few weeks since my correspondent wrote to me, "That
last Sunday she walked to church, a distance of eight miles,
there and home again."
A somewhat similar, although not so severe a case, was that
of Joseph Neill, eight years of age, who applied at the York
Homeopathic Dispensary on 12th August, 1851. He was
apparently in good health, but of a strumous diathesis. The
left knee is swollen, white and tense, painful when touched or
moved. Aconite and Arnica were prescribed internally. No
external application of any kind was ordered. The swelling
gradually lessened ; Sulphur was then given for two days. On
the 30th of August, eighteen days after his first appearance
at the dispensary, the swelling was almost gone; he walked
much better.
Sept. 6th. — Improvement continues; joint remains stiff;
Arnica embrocation was ordered. On the 27th of September
he was discharged cured.
The next case was that of John Smallwood, aet. 4 ; likewise a
dispensary patient in York. He looked delicate, of a strumous
constitution. The right knee was enlarged, and had been so
for three months without any obvious cause. Sulphur 30 was
given for a week, then Calcaric Carb. 30 for 17 days; the swelling
and pain had both diminished; a compress of cold water covered
with oiled silk was ordered.
February' 10th. — The knee is smaller, general health good;
Iodine 30 was given, and the cold water compress continued.
On the 4th of March there was no pain in the joint, — he walks
better. A week afterwards the diseased joint is found to be only
half an inch' larger in circumference than the other. Calcarea
30 was resumed, and continued imtil April 7th, when he was
discharged cured.
Another and a very simple case was that of Annie Low, set. 14,
residing' at Penge. She applied at the Sydenham Dispensary
on the 25th of March, 1862 ; the left knee was very painfid,
swollen, and evidently contained fluid. She walked with dif-
ficulty : cloths dipped in a lotion of Arnica^ and covered with
Dr, Ranrford on sonie Affections of the Knee-^oiiU, 1 35
oiled Bilk, were ordered ; in less than two weeks there was dimi-
nution of pain and swelling. On the 8th of April she reported
herself cured, and ceased to attend
The next case with which I shall trouble you was that of Ellen
Bogers, set 18, admitted at the Sydenham Dispensary, on the
1 8th of April last. She is a fine healthy girl, and states that she
fell down in December, 1862, and struck her right knee, but
did not feel any pain in the knee imtil March, 1863 ; she then
went to St. Mary's Hospital, on the 2nd of April following, as
an out-patient; she continued going until April 22. During that
time the tumour of the knee was lanced twice in one week, and
pus mixed with blood was evacuated on each occasion ; two
blisters in succession were applied to the swelling after that ;
subsequently the knee was painted with Iodine. When she came
to me, the swelling over the patella of the right knee was con-
siderable and tense, the surface raw; she walked with great
difficulty, but her general health was good. I ordered Silicea
Tinct. 6 to be mixed with lard and kept applied to the pait
aflfected. In four days she walked about freely, and in ten
days returned to her home in Buckinghamshire. This case
illustrates, in my humble opinion, the evil results of the
nimia dUigentia Chirurgici. A less heroic treatment at first,
with rest, would perhaps have been attended with better results,
but it affords fresh proof to me of the value of Silicea given
internally and applied externally.
And here I may, perhaps, adduce another instance of the value
of homoeopathic treatment, although not one of diseased joint,
strictly speaking — ^but a case which Mr. Scott would probably have
designated Chronic Inflammation. A gentleman, aged 69, resi-
ding near Barnard Castle, County Durham, wrote to me for ad-
vice on the 13th August, 1862. I have never seen him, but
give you the details of his case as I received them, though di-
vested of much irrelevant matter. In February, 1 8 6 2, he writes :
** I scratched my left ankle, and produced a wound in it larger
than a shilling ; my leg was then in places very black. I applied
136 Dr, Ransford on some Affections of the Knee- Joint
to the doctor here, to heal it, but he could not, and it discharged a
little thick white matter — then my foot swelled and puffed up. I
was advised to drink broom tea, which I did, and do still drink
it, and wear a bandage from my foot to my knee ; but this was
all to no purpose, my foot was considered dropsical, and the doc-
tor ordered me broom tea for it, and frequently applied Caustic
to the wound, which gave me much pain. Since then my leg
became full of red spots, like pin points, up to my knee ; and
these red spots, after some days, became of a scarlet red all over
my leg and foot, with much hard swelling all over my leg up
to my knee. My knee and ankle joints are very stiff and scaly ;
there is also a tremendous itching, which continues at times,
especially in the night ; the itching is likewise about my arms,
eyebrows, chin, neck, head, ears, body, and all around my private
parts, having a yellowish appearance. The wound in my leg is
not healed up ; it is small — was never very deep." According
to his own statement, he had lived freely, and took a great deal
of salt with his food ; since February he has been a total ab-
stainer. Appetite is good. He is now taking Dr. Eooker*s Pills
(which I never before heard of) : he formerly applied Tar Oint-
ment, but now rubs his leg with Holloway's Ointment ; he adds
a postscript, that he had for thirty years been much troubled with
rheumatism, and during the last ten years he had been compelled
to walk with two sticks. For this not very promising state of
matters, I ordered Belladonna and Arsenicum, to be taken alter-
nately, and Tinct. Belladonna with water to be applied on a
cloth, oiled silk to be worn outside the cloth ; the broom tea,
Eooker's Pills, Holloway's Ointment, were to be inmiediately
discontinued. In the course of a week he reported himself im-
proved, the itching and swelling of the limbs had diminished,
the limbs and joints were stiff from what he described as a hard
scaly scurf upon them; the urine had increased in quantity, not-
withstanding the discontinuance of the broom tea ; the scaly
condition abated, and gave place to healthy skin ; the urine was
described as having a deep red sediment in it. Ten days after-
1 38 Dr. Ransford on some Affections of the Knee- Joint,
pose that medicioe and diet are all that are necessary for the
treatment of local disorders, and that local remedies are needless.
We believe that it is by scrupulous attention to, and a proper
application of the latter, that will make our practice the most
successful"
Since writing the foregoing, my friend Dr. Duncan Campbell,
of South Shields, sent me two very interesting cases : from per-
sonal acquaintance I can vouch for Dr. Campbell's accuracy
in diagnosis and description, and have, therefore, much pleasure
in bringing them before you at this time. The first case
is that of Mary Wood, aged 18 years : — " She has endured
with great patience the many torturing means used by allopa-
thic science. Wood consulted me, for the first time, on the 10th
October, 1862. Before I could possibly question her, she gave
me a very fuU and descriptive account of her sufferings ; she
was leeched, blistered, cauterised, and otherwise very much
pained, in the vain hope of obtaining a cure. On questioning
her, she said she never aUed anything in her lifetime before the
occurrence of the present mishap, which took place in the fol-
lowing manner: — Coming down stairs very rapidly, and turn-
ing round on the landing, her left hand got between two of the up-
rights protecting the stair sides. Although painful at the mo-
ment, she took no particular notice of the accident till three
days afterwards ; the wrist .joints got very painful and swollen,
the part gradually got worse ; the pain she described as unbear-
able and deep-seated, greatly aggravated by pressure or motion ;
there was tenderness of the integuments, and a good deal of
constitutional disturbance. The family surgeon was then called
in: he ordered leeches and perfect rest, which orders were strictly
obeyed (a few doses of castor oil were also taken). Thus mat-
ters went on for nearly a month, but as the inflammation sub-
sided, a stiffening of the joint ensued. The stiffening went on in-
creasing, tOl at last the joint was incapable of any kind of mo-
tion ; she then submitted to a course of blistering, taking at the
same time some of the so-called alterative medicines (such aa
Dr. Ransford on some Affections of the Kiiee-Juint. 139
Iodine, Potass, &c.). These giving no rolief, the actual caut(»ry
was applied in three parallel lines on the palmar aud dorsal
aspects of the joint The wounds were kept open for nearly six
weeks ; they suppurated freely, but no good results followed.
She got tired of the mode of treatment, and an aunt (a patient
of mine) got her persuaded to try wliat I could do for her. On ex-
amining the joint carefully, I found a pci-ceptiWe motion exist-
ing between the bones composing the wrist-joint pi-ojxir ; pain
stiU existed on moving it, but the pails were much swollen from
subcutaneous effusion, — I have no doubt, brought on by the use
of the actual cautery : this satisfied me that the articulation was
not so seriously involved as supposed. Her constitution was good,
and I having diagnosed favourably, began the treatment with
Arnica lotion, of strength 3i ^o S^ii Aqua Pura, to be rubbed in
three times a day. I gave her Arnica 3 internally, every four
hours. For the first week no change was perceptible, but at the
end of five weeks she was, and felt herself, so much better, that
she asked leave to discontinue her visits at the surgery. I pre-
vailed upon her to come once a week for a month longer, which
she did, and left finally cured. I saw her two months after-
wards : she was then perfectly well.
** Remarks. — ^The treatment was not changed during the whole
time of her attendance. I forgot, however, to mention, that at
the beginning I applied a long splint, extending from the middle
of the arm to the extremity of the fingers, thus ensuring com-
plete rest to the joint involved. Tlie action of the continued
application of Arnica lotion was, in this case, very obvious, and
if it had been applied at the first, would have saved the patient
great pain and trouble."
Case 2nd.
" John H , aged 5 years, of a very scrofulous constitution,
came under my care on the 1 0th of December, 1862. The elbow
joint of the right upper extremity looked seriously involved.
Three wounds discharging a thin serous fluid, occupied the pos-
terior aspect of the joint ; slight motion existed ; the joint was
140 Dr. Ransford on some Affections of the Knee- Joint.
much swollen ; the swelling was of that soft, elastic, and colour-
less nature, so commonly seen in scrofulous affections; the
muscles of the arm and forearm were perceptibly atrophied ; the
seiiiiflexeJ seemed the easiest position, and the general appear-
ance of the little patient seemed to confirm the opinion I first
formed, — an opinion that this was a case of gelatinous degene-
ration with necrosis. His appetite was good, his bowels were
moved regularly, and he did not lose much flesh. The exciting
cause was supposed to be a fall from his crib three months
before. Arnica lotion externally, and Silicea 6 gtt. 1 three
times a day, constituted my treatment for two months; three small
pieces of necrosed bone came away, the swelling subsided gradu-
ally, but no return of motion. I then substituted Merc-Sol. 6
for the Silic, and with obvious benefit. I now applied a semi-
flexed splint of pasteboard to restrain him from abusing the
mobility of which the limb was now capable. He took Ol
Jecor Aselli 5ij morning and night, and now. May 13th, 1863,
he can take his food with ease ; the joint is somewhat stiffer
than before, the wounds have all healed up, and he is gaining
flesh rapidly. I have no doubt but that in a few months more
the joint will be perfectly restored."
" Diseases of the joints," says Mr. Listen, *' originate in a
variety of ways, and in any one of the tissues which enter into
their formation and composition. These diseases are attributable
to injury, as sprain or contusion ; but this may have been so
slight, and so slowly followed by signs or symptoms causing
alarm, as somehow to be nearly forgotten, the mischief being
then supposed to arise spontaneously, and altogether through
some vice in the constitution. Many persons are so slightly
constituted in these and other respects, that very trifling causes
operate in deranging the functions and structure of their organs
and apparatus."
" I must confess," says Sir Benjamin Brodie, " that in pro-
portion as I have acquired a more extended experience in my
profession, I have found more and more reason to believe that
Dr. Ransford on some Affections of the Knee-Joint 141
local diseases, in tie strict sense of the tenn, are comparatively
rare. Local causes may operate, so as to render one organ
more liable to disease than another ; but everything tends to
prove, that in a majority of cases there is a morbid condition*
either of the circulating fluid or of the nervous system, ante-
cedent to the manifestation of disease lq any particular struc-
ture, but the constitutional conditions giving rise to, or associated
with, diseases of the joints, are as various and as different as
the local phenomena."
In conclusion, we hope that in the details and results of the
cases which have now been laid before you, although in an
imperfect manner, we have demonstrated the value of the
therapeutic principles, simple and harmonious, with the symp-
toms presenting themselves. An inestimable boon, which let
us never forget, we owe to the genius and perseverance of
Hahnemann. We can afford to disregard the contemptuous
observation of Sir Benjamin Brodie in the fifth edition of his
elaborate work on diseases of the joints. It is an observation
unworthy of his well-earned reputation. In treating of hysteric
diseases, he enumerates various cases of sudden recovery upon
the exhibition of some new medicine, or the application of
some new plaister or liniment, which has therefore obtained,
though it has not deserved, the credit of the cure. The worthy
Baronet adds, " that, as might be expected, examples of similar
cures have been furnished by Mesmerism and Homoeopathy."
DISCUSSION.
Dr. Drury regretted that there were so few members present
to hear the valuable paper with which Dr. Ransford had favoured
the society. like others of his, it dealt more with practice than
theory, and useful hints thus thrown out often proved very
serviceable when similar cases arose. Such hints, however, to
be turned to good account, should not be allowed to lay the
foundation of a routine practice, but should rather be made
available as helps in the selection of the proper homoeopathic
remedy, or as helps in mechanical or surgical appliances or inter-
ference common alike to homoeopathy or allopathy. As diseases
of the knee-joint were not of every day occurrence in the
142 Dr. RaTisford an sorne Affections of the Knee-Joint
ordinary run of practices, the opportunity for their study was not
as groat as many other aibnents. No doubt an interesting dis-
cussion might be brought about by introducing the treatment of
scrofula, but that would be travelling out of the legitimate sphere
of the paper. The disease of the knee that most frequently came
under his (Dr. Drury's) observation was housemaid's knee ; in
tliat affection he found Bryonia, Ehus, and SiUcea most valuable
medicines. In scrofulous affections of the joint many of our
homoeopathic remedies possessed wonderful power. Amongst
others, Assafoetida was one well worthy of attention.
Dr. KussELL said it seemed to him very strange, that the attend-
ance at our meetings appeared to be the inverse proportion to the
practical character of the paper announced to be read. The more
theoretical, the more interesting apparently. Tliis he regretted ; for
such a paper as has just been read is of the highest importance, and
might elicit much useful information if fully discussed by those
who had large experience in this class of aflfections, which gene-
rally fell to the lot of surgeons. There were three different classes
of affections of the knee-joint which were apt to be mistaken for
one another — the scrofulous inflammation of the tissues of the
joint, the rheumatic inflammation, and what had been called the
hysterical knee-joint. He had had very well-marked examples
of each under his care at the same time, and in all of them he
had succeeded in effecting a cure after the patients had been
recommended to have amputation performed, at least in the two
former cases. In the hysterical it might have been, for the case
had been treated as one of white swelling of the knee-joint. In
the first case SUicea was the great remedy, and the case resulted
in anchylosis of the joint, after an illness of fifteen years. In the
second case of excessively severe rheumatic gonitis, Mercurius
was the chief medium employed, and the cure was completa
In the third case, although there was no danger, yet it proved
tedious and troublesome, and got weU as such cases do, quite
suddenly and unexpectedly.
Mr. Yeldham said some of Dr. Hansford's cases referred to
Synovitis, which he (Mr. Yeldham) considered the most curable
form of joint disease. The knee was the joint most commonly
affected, and next to that, perhaps, the wrist. A very interesting
point in the history of these cases was the rapidity with which
considerable quantities of synovial fluid often became effused,
and the almost equal rapidity of its absorption. He had recently
treated a case of this kind in a lady, who caught cold whilst gar-
dening, and in whom the left knee-joint became, in a few hours,
inflamed, painful, and greatly distended with fluctuating fluid.
Under the influence of rest, cold water, and Aconite and Mercu-
rius, the fluid was all absorbed in three days. A similar case had
Dt, Hansford on some Affections of the Knee^oinL 143
lately been under his care in one of the female wanls upstairs.
Such cases were very frequent and were satisfactory in their results.
Perfect rest was very important in joint aff'ections. lie had recently
discharged a case of synovitis of the wrist, in a young woman
from the country. Her wrist had been bad for 18 months, but
she had been aUowed to hang the limb down, and it had not
been steadied. It was very painful, and filled with fluctuating
synovia. He (Mr. Yeldham) placed the forearm and hand on a
splint, applied cold water, and gave Calcarea and Sulphur, and in
three months she was well. Position was in some cases scarcely
less important than rest. This was well illustrated in a case
which was sent into the Hospital about three years since from
Nice by their colleague Dr. Blest. It was that of a lady's maid,
who had inflammation of the foot and ankle. She had been unable
to use the limb for many months previously, and had been treated
allopathically with leeches, &c. After her admission, she was
kept in bed in the ordinary recumbent position. This and medi-
cines did but little good. He (Mr. Yeldham) then had the limb
placed on an inclined plane, considerably elevated at its distal
end; the foot thus becoming the highest part of the body.
Instant amendment followed, and she speedily recovered. In-
flammation of the ligaments and tendons of joints, arising com-
monly from sprains, he had often found to be a very troublesome
complaint ; and he had not, in his practice, generally been so
fortunate in the recovery of his patients as the author of the paper
had. He had, at that time, under care a young gentleman who
had sprained his knee in jumping. He had been under treatment
a month already, and notwithstanding that he had rested, and
applied Arnica, and Ehus, and cold water, and taken medicine
internally, the inflammation still lingered obstinately about the
joint. Of scrofulous afifections of the joint — a wide field, he
would not then say anything. Dr. Kussell had alluded to
aflfections of the joints in hysterical subjects. He (Mr. Yeldham),
some years since, had under care a very remarkable case of what
might perhaps be called nervous disease of the hip. It occurred
on a young lady who had been strictly confined to the recumbent
posture, on her back, for five years before he saw her. During
that period, she had never left her bed, nor the horizontal posi-
tion. The afi'ected limb was kept straight, and was steadied by
sand-bags, the least motion causing intense pain. The limb was
shortened, and in other respects looked like genuine hip-joint
disease. She had been seen, from first to last, by many eminent
suigeons and physicians, and amongst them, at his (Mr. Yeldham's)
request, by their President, Dr. Quin. Ultimately, it was deter-
mined to remove her to the seaside. Her bed was placed in an
invalid carriage, and she was carried to Brighton. She there
144 Retrospect of 1862.
heard of the late Mr. Hamip, the rubber. He took her in han
At the eud of three months she could walk a mile. She gotpe
fectly well, has since married, and is now in robust health. I
should state that there was, in this case, no abscess, and that tl
patient's general health was tolerably good throughout. This w
clearly not a case of idceration of the joint : but most probab
one of chronic iiiflanmiation, or nervous irritation, in the muscl
and parts sun^oimding the joint. Mr. Yeldham thanked I
Eansford for Ids very practical paper, and regretted there we
not more members present to hear it
EETROSPECT OF 1862.
Translated from the Allgemeine Horrumpathische Zeitung-
slightly abridged. By Dr. Meyer, Corresponding Member
the Society.
The fifty years* war does not slacken, but maintains itsc
fresh, and acquires new force. Who knows whether we hi
not relaxed our efforts and accepted a compromise, as indeed
sometimes indicated and recommended in whispers among i
if our opponents were not for ever renewing their challenge
Who knows whether, satisfied with our Homoeopathy, such as
was and is, we had not entirely abandoned all progress and t
effort to increase the productions of our inheritance if we hi
been permitted to settle in peaceful and friendly relations wi
our opponents ? Had we done so, it is possible that th
would openly have acknowledged what they now secret
borrow from us, and even made the admission that there w
truth concealed in our doctrines. But could this appare
felicity have long endured, if each of us had maintained wi
was most distinctive between us ? Should we not have ma
to them many little concessions, and, were it even for comp
ment sake, should we not have admitted that many of th(
therapeutical principles were not altogether objectionable ? A]
what would have been the result of this hypocritical reciprocit;
Retrospect of 1802. 145
Our opponents might perhaps have learnt something from ns ;
but, at the very least, we should have introduced impure elo-
ments into our science, which might have undermined it a
stability. But the greatest mischief which would have resulted
from 80 false a fraternisation, would have been the jmralysiiij,'
influence it would have exerted upon our efforts. We might
still have laboured, but without the requisite zeal ; we mijjht
have striven forward, but not with the openness the occasion
required, and gradually the poison of lukewarmness and indo-
lence would have penetrated our veins, and Homrjeopathy, in-
stead of advancing, would have retrograded.
To begin our retrospect with our litemture : we see how it
accumulates from month to month, and, if everything wliicli is
offered to supply the demand is not of great worth and value,
nevertheless almost every literary effort demonstrates the desire
of its author to do some real service to our cause. Our journals
are always full, and manifest that there is no deficiency of an
earnest power of labour.
Our book of books is the Materia Medica ; to it belongs the
first place in the muster-roll. None of his followers have done
so much for it, and of such noble quality, as the foimder of our
school He designed the general plan according to which all
future efforts were directed. To this work every new cycle
affords its new contribution of material ; the year just passed
has considerably enriched this department. Among others, we
have to mention a second proving of Ehus radicans, left
behind by our deceased colleague, Dr. Joslin, of New York ; a
proving of Plectranthus fructuosus, by Von Pratobevera ; and
an arrangement new in our literature of the physiological, pa-
thological, and therapeutical properties of Gelseminum nitidum,
by our indefatigable colleague, Constantin Hering. The mani-
fold and deeply working effects which seem to be peculiar to
this plant, would well repay the labour of a regular physiolo-
gical proving. Phosphorus has been proved over again by
Soige, and the results exhibited in a schema in our monthly
10
146 Retrospect of 1862.
number, which also contained that of sulphur, by Wunnb, ar-
ranged by Kraehe. In addition to these, Opium has been
revised by the Austrian Society of Homoeopathic Physicians,
which is now inviting assistance towards another proving of
Ledum palustre; while Hoppe has undertaken a proving of
Chamomilla; and Szontagh, one of Arnica. Fragmentary
provings of Lycopodium have been contributed by Baum-
giirtner; and of Veratrum album and Helleborus niger, by
Lembke. Valuable and welcome as all repetition of provings
are, yet they are all deficient in the most important atfribute,
towards which we have akeady, although unfortunately in vain,
directed attention. The object in repeating a proving is two-
fold,— the discovery of new powers, and the confirmation of
symptoms already detected by former provers. But that
these results may be clearly discerned and become of practical
utility, it is the duty of those who have undertaken the task to
indicate clearly and sharply which are the new and which are
the old and confirmed symptoms. The latter are the most
important, for such a confirmation of the former symptoms
establishes their certainty, and would warn off as a " noli me
tangere " the most rabid erasers and correctors. But if those
engaged in this work of repeating provings leave this separation
to the judgment of their readers, the design of their whole
labour has miscarried, for they will only be laid aside as
valuable material for future use. If then those who undertake
this proving over again wish to accomplish some material
advantage, they should not shun this slight additional trouble,
which would be their best recompense for their self-devotion.
Whatds called the purification of our Materia Medica, which
is said to be so much desired, has been but little attended to.
Veratrum album alone, which had already been sifted by Gerstel
has been subjected to the critical examination of the industrious
Eoth. But here too we miss, with regret, the exposition of the
final result, — we mean the definite conclusions — what syniptoms
are to be irrevocably expunged from the Hahnomannian proying,
Retra9p,rt // IRfii'. 147
what are to be retained only provisionally, and what ar<' to bo
regarded as so established that they are never to h(» nn.ddlnl
with. This determination is as indispensable as we have shown
it to be in the case of the re-proving of medi<'in<»s, <»thiTwise tin*
labour bestowed npon such a purgation has ])0<'n ])artiall\' at
least in vain. At all events such an undertakin<^ is no light
task, and at all events utterly impracticable for any sin^^'lo i»*r-
son. We willingly acquiesce in the proposal recently ina<h* by
Langheinz, that a society should be instituted whicli sh )ul«l
undertake, by the co-opemtion of its meml)ers, the sifting of our
Materia Medica. But the primary condition of siu-li an associa-
tion, from which anything of real use was to be expoct<^d, is not
the formation of any external fomis of construction, much less
that there should be set forth a regidar progmmme and a set of
rales, according to which all citations, and the so-called " o])ser-
vations of others," should be tested ; but what is wanted is, that
the pathogenesy arrived at, through the physiological proving,
should first be taken in hand and thoroughly examined, — and
this seems to us by far the most important \)tiYt of the umh.T-
taking. Some kind of programme, however, is rccpiired, tliat
everyone who wishes to join the association may weigh before-
hand whether he is competent to fulfil the reciuisitc conditions
implied in the execution of the task. For nowhere is it more
necessary to work according to a predetermined arrangement ;
in nothing could more harm arise from the admission of arbi-
trary and individual views, than in this work of critical purifi-
cation. When, however, such a plan is being formed, the first
requisite of those who undertake the w^ork will be, that they
regard the thorough sifting of our Materia IVIedica as the most
important requisition of our science. We may, perhaps, have
occasion to recur more in extenso to this matter ; at present w(»
must content ourselves with the expression of this hope, that
for such an association only those be selected who are known to
be practical as well as theoretical, and who are thoroughly versed
in out Materia Medica, and know how to appreciate its gieat
10*
1-48 Eetrospect of 1862.
worth ; but sceptics, or nationalists, as it is the fashion to term
thorn now-a-tlays, are not adapted to so grave and important a
task, for in this matter so-called Eeason, as it dealt its strokes,
niiglit play many a foolish prank and strike out at random. Of
this we have abundant examples, but at all events we would
strongly recommend to the attention of those who propose to
engage in the task, the few but pregnant words spoken by Dr.
Gross, of Barmen, that hitherto all the attempts at revision of
provings have consisted chielly in criticising quotations of historical
or personal grounds, and have dealt with what is external in re-
ference to the provings tliemselves, or to the persons who were
engaged in making them, but have neglected to observe the in-
ternal physiological harmony of the different groups of symptoms.
Nothing is easier than making erasures, but we openly avow,
that we should rather retain twenty false symptoms, than see a
single true and trustworthy one erased : an erroneous symptom
may mislead us, but to deprive us of a trustworthy symptom is
to commit an act of robbery upon us and our science. Hence
it needs the exercise of the greatest prudence and circumspec-
tion in the choice of means and ways, which are proposed for
adoption, and in the choice of the men to whose hands we
commit such sharp-cutting instruments.
Nor can we report much more progress than in the depart-
ment we have just referred to in the elaboration of our Materia
Medica. Among those wliich have appeared in this journal we
may notice a composition exhibiting the action of Glonoine, and
a scientific arrangement of the effects of Calcarea and of Aga-
ricus muscarius, taken from the excellent work of Espanet,
entitled " Traits m^thodique et pratique de Materia McJdicale
et de Thdrapeutique," a book we strongly recommend as worthy
of study by those who are masters of the French language.
Close upon the territory of the Materia Medica stand the
observations and experiments in pharmacodynamics. We shall
begin with the little that has been done in this department by
homoeopathic physicians. Pemerl gives an account of the
Rdrmpect of 1862, 149
action of Atropin, which he employed in the dose of 1-3 2nd
part of a grain, as a subcutaneous injection in a case of proso-
palgia. Gallavardin rei)orts upon the efle('ts of l^hosphorua
upon the nerves of sensation and of motion, upon tlie latter of
which this medicine exerts a i)amlysing inlhience. Kotli details
many interesting effects of Curai'o, Nicotine, irEtlur, and
AlcohoL Severa.1 additional conclusions in regard to Huiti
Brasiliensis and Cocco are given in tlie letters on Xatnnil
History which have been published in this journal. l^ahaps
we ought to include in this list the experiments ma le l)y
Hoppe with Oil of Turpentine, which he api)lied heated to the
skin, and produced all the symptoms of a bum. But more
important than these are the contributions of our allopathic
brethren to pharmacodynamics, which appi^ared in our nn'nthl}
part. Most of these were histories of casrs of poisoning. An
acute case of poisoning with PhospJioincs is detailed by Ehrle
and Wagner; with Petroleum, by Jelliuek ; with Arseni\ by
Custer; with StraTnonium, by Flogel, Konty, and Beniliard;
with Solanum nigrum, by the same authorities; with Chlornft mi,
by Lamm ; with Upas tieut^, by Mannkopf, who likewise re-
lates a series of cases of poisoning with Sulphuric Acid, wliicli
report, besides containing other interesting symptoms produced
by Sulph^cric Add, makes special mention of its exciting au
intercostal neuralgia. By experiments, but chiefly upon animal.^,
the physiological effects of Colchic^tm have been ascertained by
GoupU; the action of Quassia upon the irritable tissue (irri-
tablen Grewebe), and oiNatrum muriaticicm, by Hoppe ; of Vcrrr^
tnmi mi%de, by Cutler and others ; of Glo7wine, by Demme ; of
Digitalin, by Stadion (a most valuable work) ; of Caffeine, by
Biill; of Berherin and Ilicin, by Albers; of Alcolwl, by
LaUemand, Perrin, and Duroy; and lastly, on the peculiar
action of the Secale coimutum — a contribution to our pages by
Theod. Meyer, of Mietau, the substance of which he probably
obtained from a Eussian journal.
As yet no inspired prophet has appeared to give us a final
150 Retrospect of 1862.
decision upon the contested questions in regard to the dose.
However, if any one expects that this problem will be solved
in any such miraculous way, he wiU find himself much mis-
taken. What is here required is individual effort and indi-
vidual observation ; any one who shuns these, or believes them
to be superfluous, is incompetent on this important matter. It
is only by exact experimentation and persevering and unpreju-
diced observation, that the reading of this riddle can be obtained,
while prejudices and prepossessions make the confusion greater.
Happily, these unhealthy peculiarities disappear more and
more, and the small party which attempts to stifle the whole
inquiry by certain phrases, shrivels daily into even smaller
dimensions. Even they now seek to attach themselves to the
larger body, aware of the danger to their very existence as a
party if left wholly isolated. Our science is the sworn foe of
the materialistic medicine of the present day, and any one who
admires the latter cannot duly appreciate the former. Smallness
of dose is one of the essential doctrines and principles of Homoeo-
pathy, and it is only as to the degree of smallness that there
can be discussion among us. A previous year has afforded us
a contribution of both a practical and theoretical character.
The practical is given in a communication by Eidherr, contain-
ing a collection of cases of pneumonia, treated by a methodical
administration of different doses, the conclusion from which
was, that the most favourable results were obtained from the
highest — the 30th dilution. The hypothetical reflections and
objections suggested against this result by Schneider have as
little weight against the facts as do the four conclusions he
su))joins succeed in winning our assent. How unwarranted is
the assumption of Schneider and others, that in acute cases the
larger doses alone are proper, is demonstrated by Battmann, who
details a case of Angina membranacea cured by the high
dilutions; and the cure is so striking, that the action of
the high potencies of the medicines in this acute disease
is not attempted to be denied by the leaders of the sceptics.
Retrospect of 1862. lot
and only glossed over by an exclamation of siiriiviMo. Aegidi
also spoke in favour of the high potencies, and att(.>n)i»tcMl to
explain the nature of their effects by their analo-ry with the
imponderables. Dr. Grauvogl lias written ui)on the aritlnnetical
and physical relation of the different dilutions. On tlie otln*r
side, the deceased Gaspary believed hinis^'lf called to |:ive, for
the advantage of others, his reflections and experiences u])on
the doses of the Materia Medica; and in tlicse he makes special
reference to a conversation with Hahnemann. Eecallinir, how-
ever, to our minds the well-meaning proverb, "De niortuis nil
nisi bene," we refrain from passing a judgment upon tlicse
reflections and experiences of our depai-ted colleague. The
different views entertained ui)on the question of the dos** which
were brought before the Vienna Society by its desire, are to be
found arranged by Eidherr; and lastly, Huber, of Klagcnfurth,
brought forward proofs (for the most part already cited), derived
from animate and inanimate nature, of the positive effects of
infinitesimal quantities. The most important addition, how-
ever, to this department were the experiments to which Ozanam
subjected our preparations by means of the spectrum analysis,
by which he demonstrated the presence of the material, even in
the higher potencies. It is to be hoped that he will persevere
with his course of experiments.
Firmly established as the principles of Homoeopathy are, yet
we do well to be careful to exhibit in a clearer light how
entirely rational and consistent with nature are the premisses of
our system, by a constant reference to the advance of scientific
investigation and observations in other departments of natural
science. Towards this, in former years, our greatest contributor
was Hoppe. Supported upon his well-known vascular theory,
which was farther elaborated in an article entitled "How
do the blood-vessels comport themselves in the process of resto-
ration ?" he treated of the essence and of the limits of Homoeo-
pathy— of the doctrines of Hahnemann, that the substance
which produces a disease has the power of curing the same ;
152 Retrospect of 1862.
and he strove to establish, in a scientific and highly ingenious
method, the proper indications afforded by the subjective
symptoms, and the gradual transition into improvement and
restoration effected by the medicines. It is certain that this
vascular theory, the truth of which Hoppe has striven, by
many experiments, to demonstrate, is calculated to afford con-
clusions in regard to many physiological and pathological
processes, and most especially upon the action of homoeopatliic
medicines and their doses : but to our mind it is, on the one
hand, too wide, leaving so many ambiguities, and, on the other
hand, too narrow, while it fails to explain the law of the more
delicate specific effects in the sphere of the action of the
medicines. In the meantime, however, our best thanks are
due to this indefatigable and diligent inquirer, and we hope
that his exertions and labours will be justly appreciated. In
the same department we have to mention an article by
Schneider, of Magdeburg, on the physiology of disease and
cure. The learned V. Bonninghausen has directed his atten-
tion, in his solid style, towards the importance of the anamnesis
in the treatment of diseases, and especially of sycosis. By the
citation of the medicines which agree with Thuya in the
symptoms of sycosis, he seeks to enlarge to a considerable
extent the range of our anti-sycotic remedies. The same
author presents us with a small work on the indications afforded
by the aggravation of pain and sensibility induced by move-
ment or by repose, and thus exhibits the mistake the younger
Homoeopaths commit when they regard such apparently
trilling symptoms and distinctions as unworthy of their atten-
tion. In a separate treatise, entitled " Homoeopathy and Hah-
nemann," fuU of piety and manly rectitude, Hencke has, in
logical order, arranged all the doctrines of Hahnemann. Such
a work as this was the more demanded because the young
Homoeopathists now-a-days, unfortunately, are unwilling to
go back to the original sources, and our new guide-books to
Homoeopathy exhibit the doctrines in a too flashy and super-
Retrospect of 18r>2. 153
ficial a style. It is for this reason we wish most emphatically
to reconunend the work named above. On the primary and
secondary action of medicines, and on the alternation of
medicines, Gross, of Barmen, has expressed his opinions. In
regard to the proposition frequently tliscussed in fonnur years,
of the rebaptism of Homceopathy, we have this year sucli men
as Hering, link, and Stem expressing a most unc|iialilied dis-
approval We, too, exclaim against this anahaptism.
Let us now dii-ect our attention to the practical departments
of our science. The first work we here encounter is Kiickert's
important collection of cases, entitled " Clinical Experiences,"
the first volume of which appeared in the year 1854, and which
arrived at a provisional conclusion in the fourth volume recently
published ; whUe the publication of the supplement is only
retarded by external obstacles. In the meantime, materials
continue to accumulate, and the year that has just passed is not
less rich in published records of clinical observations than its
predecessors. We shall not attempt the particular enumeration
of each of these, because the task would be too laborious, and
the space required beyond what we could spare ; so we must
limit our observations to those narratives of cases and commu-
nications which are of special importance for the therapeutics of
certain diseases. Among these, Gerson's experience upon the
treatment of prosopalgia was most instructive. Unfortunately,
this excellent work is hitherto incomplete. Schweikert published
his observations on Cynanche cellularis Maligna, against which
he recommended anthraxin as the most efficacious remedy.
Sigmann wrote upon the therapeutics of Leucorrhcea, and
pointed out the necessity of a local examination. Freytag
treated of Amblyopia in its pathological and therapeutical
aspect. Bartl reports upon the treatment of Ophthalmia in
general and of Egystian in particular, likewise of epilepsy from
his previous hospital experience. Stern has written upon the
therapeutics of syphilis ; Clotar MUller, on Migrane ; Quaglio,
154 Retrospect of 1862.
upon Laryngismus stridulus and croup ; Buchner, aphoristically
on the therapeutics of affections of the diaphragm of Bright's
disease and uraemia ; Boyer, on his treatment of metrorhagia ;
Kidd, upon fibrous tumours of the uterus ; Mclimmont, upon
pelvic cellulitis, against which dangerous disease he recommends
next to Aconite, Veratrum viride. Besides, Kraizell conmiuni-
cates some successful cases of typhus fever ; and Hirsch describes
his experience in the treatment of pauaritum, and writes on the
prophylaxis and cure of abdominal hernias (unterleib Hemien).
The discussion which took place at the annual congress of the
Central Association turned upon whooping-cough, asthma thy-
micum, and epilepsy. Finally, Bruchner drew a parallel be-
tween the allopathic and homoeopathic treatment of symptoms
of depression and paralysis, while Bresslauer recommended a
judicious employment of the water-cure to Homoeopathists in
certain cases. We have also to mention, as of especial
worth, a treatise by Proll, entitled "Experiences and Studies on
Gastein,'* which exhibits the subject from various homoeopathic
points of view. But one of the most gratifying publications in
this province was the commencement of a work on homoeo-
pathic therapeutics, by Bahr, which supplies a long felt want,
and upon the contents of which we have already expressed our
opinion. The treatise of Kafka upon the same subject will fall
to be considered in the retrospect of next year. The following
is a catalogue of the certain medicines which have been recom-
mended against certain diseases : — Phosphorus against Icterus
7)ialignus, by Schaedler and Eavel ; Apis against Morbus
Brightii and scarlatina, by Teller ; Arnica in poisoning from
adder's bite, by Kirsten ; Argentum nitricum against chorea,
by Gross, of Eegensburg; Bryonia as an external application in
arthritis and rheumatism, by the deceased Perrutz; Glonoine
against certain forms of brain affections, by Kaeseman and Ganz ;
Mercurius iodatus against diphtheritic sore-throat in scarlet'fever,
by Kirsch, jun.; Mercurius corrosives against an epidemic
dysentery by Ellinger ; Phospholeinum against impotence and
Retrospect of 1862. 155
bashfolness in youth, by Altschul ;* Ledum palustre against
-whooping-cough — a popular remedy in Kussia — by Lembke;
the differential diagnosis between opium and glauber-solts in
lead-colic is shown by Gross, of Barmen ; and against incipient
tabes dorsalis, the rubbing in of the lumbar portion of the spinal
marrow and brain of a pig ;t besides Gelseminum scmpervi-
vens against apoplexy, by Hall ; Eumex crispus against lavi/n-
geal catarrh, by Joslin; Agaricus muscarius against chorea,
by Clifton and Bloede; Kalmia latifolia against rheumatism,
by Fretsch ; and Sarcenia purpurea for the rapid cure of small-
pox, and the avoidance of its scai*s.
The following articles are rather of pathological than of
therapeutical interest : — A treatise on the Asthma of IMsoners,
by Marschall ; an attempt at a more precise demonstration of
the causes of spasmodic dyspnoea of children and adults; an
article by Freytag, and an essay by Bohler, upon the recog-
nition of the existence of Trichia; and one, by Mayerhofer,
upon angina diphtheritica. Perhaps we should include, in
this list, an article upon the Mischief of Vaccination, by
Graham.
We will not repeat our old complaint that we obtain but
little from our clinical institutions. Much as this is to be
regretted, yet at present there seems little prosi)ect of improve-
ment, for the cause lies in insufficient remuneration of the
physicians and their assistants. Tlic Praxis axtrca must be
sought outside the hospital, and thus much is allowed to go to
* The German text is Impotenz wul Blodigkeit dor Kinder,
and the literal rendering would be " impotence and bashfulness of
children." What this means is beyond the conception of the
translator.
t Again, we are afraid to trust our senses and reproduce the
text verbatim et litteratim — Die verriebene portio lumbalis der
MedtUla spinalis und cerdyt*i Porci gegen beginnende Ruckenmarh-
Schwind'sucht: it may mean triturations of the spinal marrow
and brain of a pig, and not that this is to be rubbed in. It pro-
bably does not much signify what it means. — Tr.
156 Retrospect of 1862.
waste within our institutions which, if it could be published,
would be of good service to our science. So we must content
ourselves with the little afforded us by our hospitals in the
year 1862. We have first to mention the continuation of the
report of the hospital at Gyongyos, by Homer, which contains
much that is interesting. Then we have, from the industrious
Eidlierr, a small selection of clinical cases from the Homoeo-
pathic Hospital in the Leopoldstadt, at Vienna, and the annual
statistics of that institution; we have likewise a statistical
report on the hospital at Munich, founded and conducted by
Buchner and Quaglio ; and, finally, we have the annual report
on the results of the Leipzig Dispensary, which Clot. Mutter
subjoined to the treatise on migrim of which mention has
already been made.
When we have mentioned that our domestic homoeopathic
literature has been enriched by a most useful work from the
pen of Altschul, entitled " Eules for diet and prophylaxis for
ofi&cers and their horses," Kkewise by Grauvogl, and by a
second edition of Gullen's " Eepresentation of Homoeopathy,"
we shall have completed our survey of the scientific contri-
butions received by Homoeopathy in the year that is past.
This survey would, however, have been much more extensive
had we not been compelled to confine it to our own literature,
and thus to exclude the contributions of the foreign periodical
press, some of which have been translated into German, as, for ex-
ample, the excellent treatise of Veterinary medicine by Pemisal
Yet, from what we have detailed, every reader will perceive
that our little circle of colleagues have not been idle, but
with much diligence have laboured at the development of our
glorious science.
A further proof of this is to be found in the establishment
of two new homoeopathic periodicals: the one edited by Eidherr,
entitled " Zeitschrift des Vereins horn. CErzte (Esterreichs," and
the other, " Journal du Dispensaire Hahnemann de Bruxelles,"
by Mourcmans. Both these journals are, doubtless, welcome
RetTos^pect 0/ 186 2. 157
to our reading colleagues. We likewise take tliis opportunity
to make mention of a periodical publication comnuMict'd in
1861, imder the title, Annals of the British Ilunueoitathic
Society, and of the London Homoeopathic 11 Oi^j) it al. This journal,
which, besides containing reports of tlie tninsactions of tlie
Society and showing the activity of the London Ilonicoopatliic
Hospital, possesses other points of interest, affords especially a
brilliant proof of the earnestness and scientific sjarit wln'cli
pervades both the Society and the Hospital. In the foi-mor
there are very full and often most instructive discussions u])on
the essays read before the meetings ; while, in the latter, besides
the treatment of the cases admitted, lectures of a pathological
and therapeutical character are delivered, and thus no pains are
spared to extend a knowledge of Homceopathy, and to attract
both young and old physicians. And this devotion is shown
not to be in vain by the rapid increase of Homceopathists in
England from year to year, and by the futile attempts made
by some of the licensing bodies (especially those of Ireland) to
induce those who are entering the profession to bind themselves
never, in their whole future career, to tamper with the great
medical abomination. " E pur se muove ! " we exclaim to these
petrifying institutions. In France, too, the voice of the de-
fenders of our science becomes every day louder, and we have
in view especially the writings of Gallavardin, who, in his work
entitled " Experiences sur les Malades des Hopitaux instituds
par TAcaddmie de Mddecine," condemns the tendency of the
allopathic hospitals, and the frivolity with which, in a country
so boastful of its civilization, hospital patients are regarded as
the material for bold experiments. Although such exposures
may be received by the mass of the profession only with a
scornful laugh, yet the repetition of truth makes some impres-
sion on the conscience. Lympha cavat lapidem non forte sed
80&pe cadendo.
We have also to notice more activity among the Homceopathists
of Switzerland, as is shown by their congress at Alten, and their
158 Retrospect of IQ&2.
resolution to constitute a society for proving medicines. From
far distant lands, too, we hear of the greater spread of the doc-
trines of Hahnemann. From the Colony of Blumenan, in South
Brazils, we received a report from Friedenreich of the increasing
adhesion to Homoeopathy in that country. He likewise, in the
most handsome way, presented to the congress some tinctures
made from Brazilian plants, and a preparation of Trigonocepha-
lus jararaca. While from Chili, Garcia Fernandez sends us an
account of the extension of our system, from Smyrna we hear
of its progress, by the pen of Cricca ; and among many other
sources of intelligence, showing the strong hold it has got in
Melbourne, we may mention the reports of V. Eochlitz.
If we now survey our own German fatherland, we have not
so much to tell of the increased extension, of the elevation or
the augmented reputation which our science has here obtained.
Before there is much improvement, the prevailing school of
medicine must work itself clearer of its present gross material-
ism ; perhaps, however, the day is not so distant, when the
physicians will again learn to think. In this period of expecta-
tion we must not let our hands hang idly by our side, but we should
carefuUy watch all the movements of our antagonists with a
careful eye, so as to parry with the requisite adroitness every
attack from whatever side it may come. We have to thank
this watchfulness and tact for converting into a triumph for our
cause the movement in Prussia against freedom in dispensing
medicines. The result of their aggression is that a ministerial order
has been issued enlarging instead of abridging our liberty in this
matter. The association for establishing a homoeopathic hospi-
tal in Berlin has made good progress, and besides the regular
subscriptions, has been enriched by some handsome benefactions.
The project has our best wishes for its success. There is some
mitigation of the repressive enactments against Homoeopathy in
Bavaria, under the regime of the present more liberal govern-
ment.
To the credit of the Bavarian homoeopathic physicians, let us
Retro^ct of 1862. inji
record that out of their private means they have contributoil a
fand, out of which the assistants at Buchnor's Hospital may l»e
paid a salary. In other respects there is little change in Ger-
many, and when Frolitz asks, " How goes the time in tlie king-
dom of legitimate state medicine ?" we might reply, it is liigli
time for it to begin to reform itself, lest the people should them-
selves undertake the task : for already the matter is being taken
in hand by the Social Science Association (volkswii-thschaftliche
Verein), which has secured greater freedom for physicians, and
has done away with their dependence upon the apothecaries
(chemists). Thus Homoeopathy leads the van in the march of
external liberation. Let us stand shoulder to shoulder and en-
dure the toil and the struggle. What we cannot achieve by indi-
vidual effort, must be done by associative strength ; and it was
a happy idea of our Central Society of Homoeopathic Physicians,
to send delegates both to the Congress of Naturalists at Carlsbad,
and the Congress of Social Science, at Weimar. Fischer, of
Weingarten, Forges, and Hoppe have, with much tact and ani-
mation, fulfilled this mission. We would express both to these
colleagues and to the Central Association, our thanks for the steps
they took on this occasion, and also our wish that the partici-
pation in the meetings of the two cliief German Societies — the
" Central Vereiu," and the " Vereinigung der Homoop. (Erzte
Bheinlands und Westphaliens" — may steadily increase.
Let us erect a stone to the memory of our deceased ! Alas,
the number, in relation to the period that has elapsed, is dis-
proportionately large and lamentable, of loyal and laborious
men who have been removed from among us. In Germany
we "have to mourn Von Benniger, Degen, Glass, Hartz, Carl
Haubold, Perutz, Vincenz Vrecka, who by his efforts on
behalf of his poorer colleagues has raised his own monimient,
and Eitter Hofrath Schwarze ; in England, Atkin and Homer,
of Hull, and Eogers, of London ; in France, the learned Tessier ;
in Italy, Treppi, Director of the Academy of Homoeopathy at
Palanno (he was murdered in the open street); in Belgium, Bron,
160 Some UnjruUished Letters of Hahnemann,
of Brussels; in Switzerland, Gsell, of St. Gall; in Spain,
Aloiizo y Pardo, of Madrid ; and in America, the industrious
provor and accomplished and much loved physician, Dr Joslin,
of New York, and Eeichelm, of Philadelphia.
And that we may not close with sadness, we shall turn once
more from those who are gone to those who still remain, and
enumerate the names of the men who, to their own honour and
to the honour of Homoeopathy, have received distinctions and
decorations. To this number belong Fleischmann, of Vienna,
who has received the additional order of the Prussian Crown
(den Preuss. Kronorden); Wank, Physician to the Staff, who has
received the Archducal Hessian Ritter Kreuz of the first class ;
Gunther of Langensalza, who has obtained a Prussian Order of
Merit (Verdienst-Medaille) ; Weber, Physician, to the Queen of
Hanover, who is appointed Superior Member of the Medical
Council ; and Stens, of Bonn, who has been named a Member
of the Sanitary Council of Prussia.
In conclusion, we may be permitted to refer to the fact, that
in the year 1862 this journal completed the thirtieth yesiT of
its existence. May it continue to enjoy the favour and good
wishes of its readers and fellow- workers !
SOME UNPUBLISHED LETTEES OF HAHNEMANN.
To Dr. Staff.
KoetJien, August 18th, 1829.
Dear Colleague,
I can bear much joy and much grief, but I was quite
overcome by the surprise I got from so many and so strong
demonstrations of the kindness and love of my disciples and
friends, which overwhelmed me, on the 18th of August. And
now, as I come gradually to myself, and examine one by one
Some Unpublished Letters of Ilahnrnwnn. 1 fi I
the gifts bestowed on me by so many kind hearts, I am more
and more astonished at their magnificence and olo<^iinco, and
the amount of thought and trouble they must liave cost. 1
have not deser\^ed them: they are the fruits of ;;enerosity, allV-^-
tion, and exaggerated gratitude. I know how to vahio their
worth. I beg that you will communicate my feeble expres-
sions of thanks to the donors, and retain yourself a ^syowt
share.
Now for business. Along with this I send you a lettor
from good Dr. Hering, and I must request you to enclose tli<^
accompanying answer when you write to him, as I liare no
opportunity; it contains some of the new anti-proric medicines,
— Alumina, Causticu/ni, Natrum if., Kali, and Conivm.
I also send you an article fi*om our friend Schmit, in wliich,
by his desire, I have dropped an observation liere and there.
For a first publication (so far as I know, ho has not printed
anything yet) it is done in excellent style. I gave him the
material for it here, and compelled him, in sjnte of his mo-
desty, to put it together. We will urge him to give some-
thing more to the world. God grant it may go well with him
in Lucca !
With regard to Colonel Bock, at least he did me good service,
for he went from here to Halle, at his own expense, to see
Professor Schweickert, and made him promise to print my
article, and send a copy of it to Bnmswick, which accordingly
was done, with a letter requiring three florins as the cost of
the printing, otherwise it could not appear. I leave you to
judge of this conduct, as also of the introduction which the
Halle gentlemen have thought proper to put before my article,
the expenses of wliich Bock had also to pay. They seem to have
considered my article as an offence wliich required justification
at their hands, and save themselves with diplomatic particu^
larity of expression, as if what I had written the publisher did
not wish laid at his door. AVhat rudeness and vituperation !
I send it to you, and recjuest its return ; but I am afraiil
VOL. m. U
162 Some UTvpvhlished Letters of Hahnemann.
that, although they have swallowed the Coloners three florins,
they will yet not put the thing into the journal, and tlius tlie
whole design will be frustrated.
I beg of you, as soon as you see the article in the journal,
to inform me at once by post, that I may begin the printing
of the fourth part of the Chronic Diseases : before that I shall
not stir a step.
Ah ! how wearisome and hard it is, and how beset with
obstacles, to bring truth into the world, and overcome preju-
dice ! If the good did not itself repay the doer by the sense
of approval from above, and out of the depths of his own con-
science, then good would remain undone. With warmest greet-
ings to Eumond, Gross, Franz, and Gerstorflf, I remain.
Yours most truly,
Samuel Hahnemann.
As I am sending you a packet, I enclose the newspaper
which gives an account of our fete. I do not know where the
editor got it : not one word did he get from me. I wish the
authorship of that article of mine to be strictly concealed,
otherwise it would be immediately attacked, and its contents
would never be fairly judged.
To Dr. Hering.
Koethen, Sept. 13th, 1833.
My dear, good Hering,
I wish you joy of being in the land of freedom, where
unhindered you can work all the good that is in your heart ;
there you are in your element. To stimulate your zeal for
our beneficent art would be to pour oil upon fire. You
ratlier require to be held back that you may not injure yourself
and reminded of the care due to your health, which is dear to
all true friends of Homoeopathy.
When you get Kopp's book and the Algem. Horn. Zeitimg,
you will read with regret with what revolting impiidence a
mixture of aUopathic impotence with superficial Homoeopathy
Some Unpublished Letters of Halinnnann. 1<'»3
has b^on to be made» and placed above the pure Homoeopathy,
which is clamoured against as imperfect and insufficient for
the cure of diseases. In Leipsic, ^^tis the hea<l
of that sect, and almost all the members of the Homoeopathic
Society there belonged to it. Twice in successive years 1 had
warned them privately in a paternal and strongly woixled
pastoral letter, but they continued to carry on their monstrous
system, and they would undoubtedly have polluted the Horac^o-
pathic Hospital which was being erected with this horror, if 1
had not broken a stick over their heads in the Leipsic paper.
Then they called out that I wished to limit their freedom of
independent action, and that I was wrong in fearing tliiit they
would practise otherwise than purely homoeopathically in tlip
hospital, and that it was to be public, as a matter of course.
But they only ventured to publish in various homoeopathic
journals 's explanation, that it was his plan to
practise allopathically to a certain extent, which would have
been a scandal to all the world, and brought our science to
suspicion and reproach, if I had not launched my thunderbolt
upon them. A certain Dr. Kutschman advanced to their de-
fence, whom I drove home ; then followed and
, who audaciously maintained that bleeding, leeching,
&c., were indispensable to cure, according to their experience.
I could have answered, but I did not like, that their deficient
homoeopathic knowledge was not the- standard of the full
powers of the system ; that they left many uncured and sent
them to their grave, whom a true homoeopatliic treatment would
have rescued. The whole Leipsic Society threatened me with
open enmity ; however, I let them proclaim their false teaching,
which they called eclecticism, in the Algem. Horn, Zeitunff, and
thus they drew upon themselves a public stigma in the eyes of
all the true disciples of Homoeopathy. In the meantime, in
the 5th edition of the " Organon," I have done full credit to
this movement. This scandal caused me, however, much dis-
tiefls.
164 Lecture by Dr. Russell
On the 10th of August I had some 20 of the best disciples
with me. Bonninghausen was among them, and they all came
to the unanimous conclusion, that a true Homoeopathist, besides
giving a simple and carefully selected medicine for a disease
ascertained with care, would also avoid all palliatives and every-
thing that would weaken the patient, as well as all external
stimulation by irritants. God help you in your good efforts, and
Believe me, yours truly,
Samuel Hahnemann.
ON SOME MOEBID AFFECTIONS OF THE NEEVOUS
SYSTEM.— BY DR EUSSELL.
Lectuke I. — Epilepsy.
Gentlemen,
On looking over the- tables of the diseases treated in this
Hospital during the last year, I was struck with the small number
of recoveries entered under the heading "Diseases of the Spinal
Marrow and Nerves." Out of 27 cases only 2 are returned as
cured, 1 0 were much improved, and 8 left very much as they
entered. The list includes cases of hemiplegia, hysteria, spinal
irritation, cerebral affections, spinal disease, mental derangement,
and partial paralysis. It does not embrace epilepsy, as epileptic
persons are generally able to attend among the out-patients.
If it had, the statistical returns might have been somewhat
improved. As these at present stand, we perceive that the
diseases of the nervous system are really the most formidable
class we encounter in our practice, and unfortunately this class
is probably greatly on the increase in this country, and in every
country where there is a perpetual struggle for existence on the
part, not only of the working population — whose firataies, when
an EpUtpsy, 165
they give way, generally suffer from rheumatism or bronchitis —
but also equally or more on the pai-t of the upper classes, who
live by their brain and nervous system, and wlio, besides tlie
constant strain under which the strongest often succumb, are
exposed to sudden vicissitudes of fortune.
I propose to confine my obsef\'ations in tliis lecture to tlie
subject of Epilepsy.
It is calculated (Sieveking, p. 80) that tliere are alx)ut
56,000 epileptic persons in England. Most, if not all of them,
are under medical care : thus it happens that all practitioners
of any reputation have almost always one or more cases of
this disease under treatment. Now, when we consider the
extreme severity and the long duration of the complaint, the
distress and anxiety it causes to the relatives of the patient,
the obscurity and perplexity of its pathology, and the uncer-
tainty in regard to the proper method of tieating it, we need
not be surprised that it should be a favourite subject for dis-
quisition by medical authors, and its literature should be very
extensivCj It would be out of place here to enter upon an ex-
amination of what has been written even recently by many
able and justly celebrated men; but I shall freely use the
information their works supply, while endeavouring to afford
the material for a satisfactory reply to the questions which are
pretty sure to be asked of us when an epileptic patient is pro-
posed to be placed under our care.
The first question which we are pretty sure to be asked is,
" What are the chances of the patient's recovery ? " From what ?
The term epilepsy represents a very complex and varied series
of phenomena, and we must, before giving an opinion, ascertain
the kind of epilepsy with which the person is afflicted. Tliere
are two very distinct forms ; the one called in the language of
science epilepsia gravior, the other epilepsia mitior, spoken of by
French and some English writers as le grand and le petit mal, and
familiarly .described by one of the out-patients of this Hospital,
as *' 1m fits and his starts'' Of the true epileptic fit, or falling
166 Lecture hy Dr, Russell
sickness, there is no need to give a description. When once
seen it is impossible to forget. It is not likely to be mistaken
for anything else, or anything else for it. Sometimes there is
a difficulty in discriminating between certain forms of hysteri-
cal convulsions and epilepsy. I believe, however, that a careful
history of the case will almost always enable us to decide. As
a general rule hysteria may be safely considered as a peripheral
affection of spinal and other nerves, while epilepsy is a central
affection of those parts of the nervous system which are included
in the encephalon — i. e., the brain proper, the cerebellum, and
the meduUa oblongata. It is very rarely that we find the
mind affected in hysteria ; at the same time I have met with
cases where there was temporary aberration of reason, along with
violent clonic convulsions, attended with unconsciousness and
ending with sleep, and yet which were undoubtedly shown by
the course they took, and the previous history of the patient's
complaints, to be of a hysterical kind and not to be epilepsy.
Some writers lay much stress upon the state of the pupil
as a diagnostic sign: I have no great faith in this. It is diffi-
cult to get a good view of the upturned eye of a person
rolHng on the ground and struggling violently, and I have ob-
served the pupils in hysteria dilate just as much as they are
said to do in epilepsy. The attacks of epilepsia mitior present
a great variety ; sometimes they are simply what the term im-
plies— fits of a kind similar in their character, but much slighter
in degree than the regular fits, lasting it may be for one or two
minutes ; sometimes they appear like what might be described
as a transient blush of the brain (as it were) : there is a momen-
tary suspension of consciousness, and the slightest possible
tremor of the hands, and it is over. But there is another form
bearing an exact resemblance to natural somnambulism, or to
tlie condition of persons in that curious state known by the
absurd name of electro-biology, which seems nothing more than
somnambulism artificially produced. I had for some time under
my care a patient afflicted with true epileptic fits, who was.
on Epilepsy. 167
besides, subject to these attacks of somnambulism in the day-
time. On one occasion she called upon me at the usual hour
for receiving patients, and took her place in the waiting-room.
When she was told by my servant that I was disengaged, she
rose and walked into my consulting room, sat down, and
answered questions quite coherently, although her manner was
somewhat strange and absent. However, I had no idea she was
unconscious till she suddenly started, and declared she? had
dropped a piece of money : this she had ceilainly not done in
my presence, and her purse was in her hand. It was a clasp
purse and shut. On looking in the waiting-room, the nnjney
was found on the floor. Immediately after dropping it she had
passed into the state — a kind of sleep — her actions were no
longer influenced by direct volition, but probably by the obscure
dream-memory : by this impulse she walked into my room and
took her seat, and she answered questions as some persons do
when asleep. The condition is a most curious and interesting
one, and well worthy of attentive consideration by psychologists.
It is wonderful to find a person who is imdoubtedly in a state
of unconsciousness, and not responsible for her words or actions,
returning coherent replies to the questions put to her. Tlie
knowledge of this condition may throw doubts upon the legal
and moral responsibility of women in some cases of child murder.
At all events, it is well that we should be acquainted with the
fact, that persons may move and talk as if they were awake
and rational, while all the time they are in a profound uncon-
sciousness, and this suddenly and in the day-time; and in
circiimstances where the absence of their natural intelligen(»(3
would not for a moment be suspected by any one unacquainted
with their habits, or the nature of the malady under which they
laboured.
On the frequency and rarity of these intermediate attacks,
and their lightness or severity, the prognosis of any case of
epilepsy in a considerable degree depends. It seems to be gene-
rally admitted, that the frequent recurrence of these slight
168 Lecture by Dr, Russell
attacks is more unfavourable as regards the cliances of recovery,
than the severity or even the frequency of the regular fits.
If the epileptic patient be under puberty, and especially if
of the female sex, much is hoped for from the change that
attends the attainment of that condition. This is a popular
belief — I fear it is a popular fallacy. That epilepsy often
occurs at that age for the first time is undoubted, and quite
in accordance with what we should expect ; for, according to the
Latin adage, Coitus brevis epilepsia est ; and sexual excitement of
any kind produces a violent perturbation of the nervous system
and brings the muscular combinations more directly under the
influence of the motions and less under the control of the
will — thus favouring all convulsive actions. But any reason,
except the deceitful one, that what we wish that we believe,
there is for expecting an existing epilepsy to be removed by
the setting in of puberty, I never could see, and I confess my
own experience is dead against it. On this point I find myseK
at variance with one of our very few systematic writers — I
mean Dr. Laurie. In his well-known and very popular work,
he says : " When the disease occurs before the age of puberty y or
when purely sympathetic (which, by the bye, epilepsy never is),
it is generally curable without much difficulty by means of
homoeopathic remedies." If Dr. Laurie's conviction of the
early curability of those cases of epilepsy which appear about
the eighth year, or from that to the tweKth, be derived from
a sufl&ciently large number of cures, he would lay the profession
under a serious obligation by publishing the details of their
treatment, as in this matter his experience is opposed to con-
current medical testimony, and is in accordance with universal
popular belief.
In connexion with the influence of the development of
puberty, we may glance at the allied question of what is likely
to be the effect of marriage upon a person affected with epilepsy.
We know that hysteria is often cured by marriage, and that on
the whole we are safe in expressing an opinion, that the fact of
on Epilepsy. 1G9
a woman being hysterical is no banier to her marriage. Can
we say so much of epileptics ? This most important question
has been fully discussed by many able writers. (See Sicvekiiig,
p. 140.) It presents itself in various aspects to our attcntiun.
First, in the simply medical point of view, thus : whether is it
safer for a man affected witli epilepsy to undergo marriage and
its consequence, or to abstain ? That some cases of epilepsy
have had their origin in consequence of marriage is a well-
known fact. On the other hand, it is athrmed by many credible
authorities, that similar results have followed from enforced
abstinence. A curious case of the latter description once came
under my own notice. It was as follows : — A gentleman of
about twenty-four or twenty-five years of age had his leg dis-
located at the hip-joint. The dislocation was not reduced, and
the head of the femur had to make a new socket for itself in
the ilium. To enable it to do so, the patient was obliged to Lie
constantly on his back ; otherwise he was in the enjoyment of
a fair share of health, of a most agreeable disposition, highly
cultivated, an only son, and of high worldly expectations. In
this situation he became attached and en^xiged to a lady ; and
the only hindrance to the match being the state of the limb, he
impatiently waited the time when he should be able to stand
and walk, even with crutches. He so far recovered as to do so.
The marriage-day was fixed, and the guests were invited;
among them one of the most influential noblemen in England,
kinsman of the bride. A death in her high circle of relations
obliged the postponement of the ceremony for ten days. Two
days before that interval had elapsed the surgeon in attendance
(along with myself) on the case was sent for in great haste. On
arriving at the house he found the gentleman in a severe true
fit of epilepsy, in which he expired. There was no post Tnortcm
examination, but I had no reason to suspect any other cause of
death. There was no previous indication of any affection of
the heart. The particulars of the last fatal struggle were fully
detailed to me at the time by the surgeon, who enjoys a high
reputation,. and who gave it me as his opinion that the death
170 Lecture by Dr, Russell
was owing to an epileptic seizure, brought on by the prospect
of his approaching marriage, and the excitement and restraint
of his sexual desires. As a youth he had been of a very
amorous disposition, and his accident had prevented him from
indulging it.
Admitting the facts of this case and the inference, they
may be interpreted either for or against the prudence of
matrimony in the circumstances. It is quite possible that,
had this gentleman married on the day he first intended, he
might have escaped his melancholy fate. At the same time, it
is quite possible that the latent epileptic forces which slum-
bered in his brain might have been called out into equally fatal
energy by the consummation of the marriage act, and have
made his end even more tragical Thus, we are compelled to
leave the question as to the propriety of the marriage of an
epileptic person for the decision of the parties chiefly interested.
All we can say is — it may do good, and it may do harm, and
it may do neither good nor harm. But, beyond this, if we
enter upon the general expediency of the step, we have no
difficulty in coming to a conclusion against it, especially if the
epileptic be a woman. On this point, we have a clear voice of
warning, furnished by statistics; for we find that out of 110
epileptic persons there were 31, or nearly one-third, who had
epileptic parents, or near relatives, and (what is still more con-
clusive) 14 epileptic women gave birth to 58 children. Of
these 58 so born, 37 had died under 14 years of age, and
almost every one of these 37 had died of some convulsive
disease. With such facts before us, it may be our duty to
warn any epileptic who asks our advice on the question of
marriage, of the dreadful consequences he is likely to entail
upon his offspring — if the marriage be fruitful. If, however,
from the age of the parties, or any other cause, there is no
chance of offspring, this would materially modify our opinion
as to the expediency of the^'step. When we are asked to give
our opinion as to the probable course and termination of a case
of epilepsy, it is likely that we shall be pressed to say whether
on Epilepsy, 171
there is great danger of its destroying the mind, and, un this
point, we should be well prepared to give exact information.
The prevailing belief, both popular and professional, is, that
epilepsy is very apt to end in idiocy, or some other form of
insanity. Now, there is no doubt of the close connexion of the
two conditions; but Dr. Badcliffe ver}" pertinently observes
that epilepsy as often begins as ends in madness, — that is, the
condition of the brain which induces the latter condition favours
the development of the former, and thus we are apt to be
misled and to take too unfavourable a view of the prospects of
an epileptic patient. The fact is, that the subjects of epilepsy
fell into the hands of what are popularly called the mad-
doctors. They found their epileptic patients going on from bad
to worse till they became perfect idiots, and this they ascribed
to the epileptic attacks, whereas the chances are that the fits of
these poor creatures were owing to the causes of their fatuity.
A more careful study of the matter has led to a different
conclusion, and the result is, that we have one of the most
recent writers on Epilepsy giving as the result of his induction,
that " the duration of epilepsy is per se without influence upon
the mental condition of the epileptic." (Russell Reynolds,
p. 173.) So far as my own experience goes, it entirely con-
firms this opinion. I have had the opportunity of observing a
considerable number of epileptics, as I happened to have had
one or two veiy striking recoveries in my practice a good many
years ago, and, in consequence, there was quite a msh of this
class of patients. At that time, I had the impression that there
was a progressive deteriomtion of the powera of the mind as a
rule ; tut I have not found it so. I have watched a good many
of these 'patients, and, I am sorry to say, I have not, in many
of them, seen improvement. Still, although the fits have been
as' frequent and as severe as they ever were, yet the mind, if it
has not developed, has not retrograded. However, I have
seldom observed the natural development to go on. Epilepsy
seems to blight its powers of growth, to arrest the mind in the
172 Lecture by Dr. Russell
state it was in, hut frequently to do no more. Out of 64 cases
of t7^e epilepsy observed by Dr. Eeynolds, in 24, or above 38
per cent., the intellect was wholly unimpaired ; in 20, or above
32 per cent., there was only slightly impaired memory for
recent events ; in 9, or about 1 5 per cent., the apprehension,
as well as the memory, was impaired ; and in 9 there were
general confusion of ideas, amounting to imbecility. If the
whole number — 64 — be too small to permit us to accept of
the propositions exhibited by these figures as altogether trust-
worthy, they are large enough to prevent our accepting the
general notion that epilepsy, if imchecked, passes, as a rule, into
mental imbecility. In quoting the tables, I emphasized the
true prefixed to the word epilepsy ; for, probably, one main
cause of what seems to have been an erroneous impression in
regard to the effect of epilepsy upon the mind was confoimding
this disease with cases of epileptiform affections depending
upon tumours of the brain — in which disease, along with the
most dreadful convulsions, we have utter prostration of the
mental powers.
Another favourite fallacy is, that much may be done by
attending to the general health. Now, this requires special
attention, if there be any such derangement of the health as
is or may be an exciting cause of the paroxysms — e, g.
intestinal worms — then we may reasonably hope that, with
their removal, there will be a cessation of the fits. But even
here, we must not be too sanguine. We must remember that
" fits," entirely caused by worms or by teething, are not
epilepsy ; that they are merely peripheral irritation, exciting an
action on a comparatively healthy central nervous system ;
which action subsides when this irritation ceases. But in-
testinal worms may be present in a person predisposed to
epilepsy, and be the exciting cause of the first attack. If this
be the case, we have no reason to expect to effect a cure of the
epilepsy by merely removing the wormsf. Any excitement may
rouse the latent epileptic condition into active manifestation.
on Epilepsy. 17»^
For example : " I have seen," says Van Swieten, *' a very
healthy girl of ten years of age, bom of sound parents, who
never had epilepsy, rendered epileptic for several years, and tlie
first time she was seized was upon having her soles tickled by
some girls who were at play with her, some of them holding
her fast upon the floor to prevent her avoiding the intolerable
sensation.'* Now, as school-girls have tickled school-girls, and
school-boys school-boys, from time immemorial, and this is
the only case on record of such tickling having given rise to
epilepsy, we may unhesitatingly conclude that although, in one
sense, the tickling caused the epilepsy, yet it would not have
done so had not all the materials for explosion been ready
to ignite upon the application to them of ani/ spark ; and that,
if instead of being tickled this girl had eaten too many raw apples,
or any other indigestible food, or if worms had been generated
in her intestines, she would equally have had her epilepsy.
It is too late now to attempt to comfort her companions, who,
from the way the case is told, must have gone down to their
graves a century ago, with this sin upon their conscience ; but
it is not too late to point out the absurdity of promoting a
mere accidental exciting cause into a primary agent in the
production of this disease. And if we, on finding that a
paroxysm of epilepsy was first caused in any given case by
worms, at once jump at the conclusion that all we have to do
is to remove the worms, we shall commit a grave error, and
may give rise to unwarrantable hopes and bitter disappoint-
ment. While, on the one hand, we cannot always give security
against the recurrence of the fits of epilepsy, by removing the
exciting cause which originally induced the paroxysms — as, for
example, irritation of the gums from teething— on the other
hand, the attacks of the disease may be held in abeyance for
an indefinite length of time by arresting the propagation of the
irritation from the circumference to the centre. Dr. Brown-
S^uard, in his treatise on Epilepsy, quotes from Odier a strik-
ing case in point. A man had frequent cramps in the little
1 74 Lecture hy Dr, Russell
finger of his left hand. The contractions went on increasing in
extent and frequency ; they by degrees extended to the fore-
arm, the arm and the shoulder, always beginning in the little
finger. At last they arrived at the head, and then true fits of
epilepsy, with loss of consciousness, took place. By means of
two peculiar ligatures round the arm and the fore-arm, and
which the man could tie easily, when ie felt contraction of
the little finger, the attacks were prevented at every threaten-
ing for two or three years. Unfortunately, one day, he ate
and drank too much, and being intoxicated he forgot the liga-
ture, when the initial cramp appeared, and then he had a
violent fit. From this time the ligature had no more influence
over the fits ; they became very frequent, and always began in
the little finger. Paralysis came on, and the patient died in
coma. On examining the head of this patient, an enormous
tumour was found in the left side of the brain, below a place
where the cranium had been wounded long before. "This
case," adds Dr. Brown-S^quard, " and the facts observed in my
animals," (i. e. the animals on which he had experimented,)
" positively show that the apparent outside origin of epileptic
fits, does not prove that there is not an organic cause in the
nervous centres." A somewhat similar case is related by Dr.
Eeynolds, who once witnessed and himself arrested the invasion
of the epileptic force. " The attacks," he writes, " are always
preceded by a stabbing pain in the lower part of the belly of
the left biceps muscle, on the inner side especially. The pain
is not in the skin, but deeper, and seems to go through the
arm. If this joint is immediately grasped, so as to press both
skin and muscle against the bone, the pain ceases in a few
seconds, and nothing more occurs. If pressure is not exerted
directly, the biceps contracts and draws up the fore-aim, and
it requires firmer grasping and drawing up of the fore-arm to
prevent the attack. The pressure must be exerted on the
biceps ; the effect is not produced by directing it upon the
trunks of the nerves, or upon the blood-vessels. Once, while
oti Ejnhpny, 17"»
a fit was arrested with my own hand, I ohservod both radial
and ulnar arteries to be still pulsating. There in no doubt
about the fact that this pressure does, in some way or otlicr,
arrest the attacks; it effects more than a relief of pain, which
might or might not run on into a paroxysm. This I had occa-
sion to establish once by an attack coming on while I was
talking to the patient. He said, ' Here it comes/ and Ids face
betrayed great horror ; his respiration ceased, and his pupils
dilated widely. I grasped the arm firmly, and the natund
expression of face returned, the pupils contracted, the face
flushed, perspiration broke out, and nothing more occurred.
He did not lose his consciousness. The fits when, as he ex-
presses it, 'they get past the arm,' are fully developed jm-
roxysmjs of epilepsia gravior." (Op. cit., p. 94.)
These two very instructive cases demonstrate the possibility
of keeping even the worst class of cases of epilepsy in a state
of abeyance, if we can discover what gives the initiative to the
paroxysm, and cut this off, so that it does not get into the inte-
rior, as it were. We gather too, from these histories, the lesson
of the necessity of a very careful investigation of all the steps
of the process of the complex series of phenonena called "a fit;"
and if we see our way, either by mechanical contrivances or by
medicine, to get hold of the first link in the chain, then we
become masters of the situation, and may, without imprudence,
hold out a fair hope of averting the dreadful consequences that
follow, if the evil is not arrested at its origin.
I had lately under my charge a patient suffering under
epilepsia gravior, the first symptom in whose case was a fulness
of the veins of the back of the neck. I never had myself an
opportunity of observing this, but it was described to me by the
mother of the patient, a person of education and intelligence,
and she informed me that the only treatment that had done her
daughter any good, during the sixteen years under which she
had suflFered from the disease, was a course of medical rubbing
by Mr. Beveridge, of Edinburgh. In this case we may presume
176 Lecture by Dr, R%issell
that the exciting cause of the attack was venous congestion of
the brain. We know from the experiments of Sir Astley Cooper,
that interfering with the proper circulation within the head
will produce convulsions. These experiments are so important,
that it may be as well to advert more fully to them. He states
that, having tied the carotid arteries of a rabbit, respiration
was somewhat quickened, and the heart's action increased, but
no other effect produced. In five minutes the vertebral arteries
were compressed with the thumb, the trachea being completely
excluded. Respiration almost directly stopped, convulsive
struggles succeeded, the animal lost consciousness, and appeared
dead ; the pressure was removed, and it recovered with a con-
vulsive inspiration. It lay upon its side, making violent convul-
sive efforts, breathed laboriously, and its heart beat rapidly ; in
two hours it had recovered, but its inspiration was laborious.
The vertebrals were compressed a second time, respiration stopped,
then succeeded convulsive struggles, loss of motion, and apparent
death : when let loose its natural functions returned with a loud
inspiration, and with breathing excessively laboured. In four
hours it was moving about and ate some greens. In five hours
the vertebral arteries were compressed a third time, and with the
same effect, — in seven hours it was cleaning its face with its
paws. In nine hours the vertebral arteries were compressed for
the fourth time, and with the same effect upon the respiration ;
after thirteen hours it was lively. In twenty-four hours the
vertebrals were compressed for the fifth time, with the same
result, viz. : suspended respiration, convulsions, loss of motion,
and unconsciousness. After forty-eight hours, for the sixth
time, the same results were obtained by pressure. Thus it
appears, if the carotids are tied, that simple compression of the
vertebrals puts an entire stop to the functions of the brain.
The experiment was reversed, the vertebrals tied, and the carotids
compressed, with similar results. Tieing the vertebrals caused
the breathing to become laborious, the animal's right ear fell,
and the right fore-leg was partially paralysed ; in five hours it
OH EpilejWf. 177
ran about. The following day, when the carotids were com-
pressed, it fell on its side, losing all sensation and volition, and
recovered on withdrawal of pressure. Tlie same results were
repeatedly obtained. When both vertebral and carotid aiteries
were tied at the same tiinc, the animal breatlicd no more ; but
there were thirteen to fourteen con\Tilsive contractions of tlie
diaphragm, and convulsions of the hinder extremities, and tlic
animal ceased to exist. (Guy's Hospital Reports, vol. i. p. 457.
Sieveking, op. cit., p. 196.)
Although these experiments by no means prove tliat venous
cerebral congestion, or a defective supply of arterial blood, is the
cause of epilepsy, yet they establish, beyond a doubt, that such
a condition of the brain excites convulsions ; and if the person
in whom this congestion takes place be of an epileptic habit, then
there can be no question that in sucli a person it will give rise
to true epileptic paroxysms, and that, upon the relief of the
congestion, the immunity from attacks will in a great measure
depend. In giving an opinion as to the danger to life, our at-
tention should be directed to the state of the tongue — if this
presents marks of having been bitten, it is affirmed by Schroder
van der Kolk that there is less risk of a fatal termination of
the disease. Tlie reason he assigns is this. The most danger
to life is from violent irritation of the par vagimi. Now he
found that in patients who had habitually bitten their tongue,
the capillary vessels in the course of the hypoglossal nucleus
in the medulla oblongata were of a greater i^roportional size as
compared with those in the track of the par vagum, than in
epileptic patients who had been in the habit of biting their
tongue. The opinions of this celebrated anatomist upon this
point, which seem to have been suggested by his observations
on the morbid structure, have received confirmation from the ex-
perience of practical observers, and we may accept them as so far
established, and assign to the presence or absence of this symp-
tom a place among the facts on which we form a judgment of
the probability of a sudden fatal termination of any given case.
YOU m. 12
178 Lecture by Dr. Russell
It may be well here to enter somewhat more fully into the
pathology of epilepsy, as undoubtedly the subject has been
more successfully investigated in recent times ; and if we have
not arrived at a solution of all the difficulties, we have at all
events received some useful hints for the direction of our cura-
tive efforts.
Dr. Schroder van der Kolk regards the medulla oblongata as
the centre of general reflex actions, and, of course, as the starting
point of epileptic and other convulsive diseases. He considers
that, however remote the seat of the primary irritation may be,
that in the medulla oblongata is the mine which is always fired
wherever the train be led from. Hence, he has directed his
special attention to the investigation of the minute morbid
anatomy of this portion of the nervous system. The general
results of his observations are, that in all dissections of the
medulla oblongata in epileptics, whether or not death took
place during a fit, he met with great redness and vascular
tension in the fourth ventricle penetrating into the medulla
oblongata, sometimes to a considerable depth. Transverse
sections through the whole medulla oblongata, from beneath
the jpons varolii to the inferior extremity of the corpora olivaria,
exhibited the part in the vicinity of the fourth ventricle of a
much darker colour, usually containing some more distended
vessels, which then ran either in the course of the roots of the
hypoglossus into the corpora olivaria, or in the course of the
vagus, and accessory or in both. Where the degree of redness
was slighter, it was commonly confined to the posterior half of
the medulla ; in most cases, however, this hypersemia extended
into the corpora olivaria, which were often furnished with
large blood-vessels. Thus, also in the raph^, dilated blood-
vessels were almost always visible. After Schroder van der
Kolk had discovered the close connexion between the corpora
olivaria and the hypoglossus nucleus, he found dilated blood-
vessels exactly in this course in the first epileptic patient^
whose brain he subjected to a microscopic examination. On
on Epilepsy. 179
measuring the width of the vessels under the microscope, the
widest vessels in the course of the hypoglossiis were found to
amount to 0.230^** (two hundred and thii-ty tliousundth) part
of a miUem^tre ; in the corpus olivare, to 0.305 niillcmetre ;
in the vagus, to 0.152 millom6tre. lie connected tliis pre})on-
derance of the diameter of the capillaries in the course of the
hypoglossus over that of the vessels in the track of the vagus,
with the fact that the patient had invariably bitten his ton^^ue
in the fits. On the other hand, he discovered that in a patient
who had never bitten his tongue, but in whom the respiration
was generally disturbed, the vessels in the course of the vagus
were much larger than those in the course of the hypoglossus-
Hence, the inference we have just noticed, that inasmuch as
the functions presided over by the vagus are of more import-
ance to life than those under the direction of the hyi)oglossus,
so there is the greater risk in propoiiion as the former, and
lesser risk in proportion as the latter, are those chiefly affected
in any given case of epilepsy. However, it by no means fol-
lows, as an absolute rule, that in cases in which the h^^^oglossus
is much affected, the vagus is comparatively little so; they may
both be equally largely diseased, and in such a case, of course,
the biting of the tongue would give no security ; the respiration
would stiU be in as much danger of being seriously affected,
and compromising the life of the patient.
The extreme difference between the diameter of the blood-
vessels of the hypoglossus in a healthy subject, and an epi-
leptic, is as 0.306 to 0.096, i. e. as the 306*-^ part of a thou-
sandth of a millemfetre to the 96*^ part of a thousand ; in the
vagus, as the 0.237 is to 0.111. Upon such infinitesimal dif-
ferences depend health with all its enjoyments, and epilepsy
with all its privations and miseries ! If this slight dilatation of
the capillary vessels were in a part exposed to view, — the eye,
for example, — how easily would they be controlled by applying
to the part some remedial agent, whose specific operation took
.effect upon these vessels. Could we succeed in discovering
Bome substance, whose action upon the vessels of the medulla
1?-*
180
Lectwre by Dr. Russell
oblongata is equally determinate, we might then indulge the
hope of curing epilepsy, as we do iritis.
Before entering upon the consideration of how we are to do
so, and what substances hold out the best prospect of being
useful, it will be well to give the analysis of the pathological
changes in a fit of epilepsy, as these have been suggested by Dr.
Brown-Sdquard. These he has arranged in such a way as to
give a tabular view of what he considers to be the causes of
the various phenomena observed in a paroxysm of epilepsy.
1. Excitation of certain parts
of the excito-motory side of
the nervous system, i. e., any
irritation by tickling, worms,
&c.
2. Contraction of the blood-
vessels of the face.
3. Contraction of the blood-
vessels of the brain proper.
4. Extension of the excitation
of the excito-motory side
of the nervous system.
5. Tonic contraction of the
laryngeal and of the expi-
ratory muscles.
6. Farther extension of the
excitation of the excito-
motory side of the nervous
system.
7. Loss of consciousness and
tonic contractionof thetrunk
and limbs.
8. Laryngismus trachaeismus,
and the fixed state of ex-
piration of the chest.
1. The effect of this is con-
traction of the blood-vessels
of the brain proper, and of
the face, and tonic spasm of
some of the muscles of the
eye and face.
2. Paleness of the fiace.
3. Loss of consciousness and
accumulation of blood in
the base of the encephalon
and in the spinal cord.
4. Tonic contraction of the
laryngeal, the cervical and
the expiratory muscles.
Laryngismus trachseismus.
5. Cry.
6. Tonic contraction extending
to most of the muscles of
the trunk and limbs.
7. FalL
8. InauflGicient oxygenation of
the blood, and general ob-
atadd to the mtraaoe of
on EpUepty,
181
9. Insufficient oxygenation of
the blood, and many causes
of the little oxygen absorbed,
and detention of the venous
blood in the nervous centres.
10. Asphyxia, and perhaps a
mechanical excitation of the
base of the encephalon.
venous blood into the chest,
and special obstacle to the
return from the head and
spinal canaL
Asphyxia.
10. Clonic convulsions every-
where; of the bladder, of
the uterus, erection, ejacu-
lation, increase of many se-
cretions, efforts at inspira-
tion.
Cessation of the fit, coma
11
or fatigue, headache, sleep.
11. Exhaustion of nervous
power generally, and of re-
flex excitability particularly,
except for respiration. Ee-
tum of regular inspirations
and expirations.
It may be well after this very ingenious analysis of an
epUeptic seizure, as explained by Dr. Brown-S^quard, to con-
sider how the same phenomena are explained by Professor
Schroder van der Kolk. " I think," he says, "we have suflacient
reason to conclude that the first cause of epilepsy consists in
an exalted sensibility and excitability of the medulla oblongata,
rendering the latter liable to discharge itself, on the application
of several irritants, which excite it in involuntary reflex move-
ments. The irritation may either be external (irritation of the
trigeminus), an irritated condition of the brain, or, as is still
more frequent, it may proceed from irritants in the intestines.
Acidity, a torpid state of the bowels, &c., are among the
most common causes ; in adults there may be irritation of the
intestines, particularly of the mucous membranes, constipation
and enlaigement of the colon connected therewith ; but above
all onanism, which acts so very much on the medulla oblongata,
and moat be r^arded as a very frequent cause of epilepsy.
182 Lecture by Dr. Russell on Epilepsy,
Amenorrhoea, chlorosis, plethora of the uterus, hysteria, &c., are
also to be enumerated.
" In the commencement, there is stiU only exalted sensibility.
If this can be removed or moderated, the epilepsy gives way
of itself, especially if the sensibility (i. e., over-sensitiveness) is
not renewed by remote causes. But if the disease has already
lasted long, organic vascular dilatation (as before described)
takes place in the meduUa oblongata, the consequence of this
being that too great a supply of blood is detained there, and the
ganglionic groups are too strongly irritated, too quickly over-
charged. Every attack then becomes a renewed cause of a
subsequent attack, as the vascular dilatation is promoted afresh
by every fit. Lastly, increased exudation of albumen ensues
from the now constantly distended vessels, whose walls at the
same time become thickened, producing increased hardness
of the medulla, subsequently passing into fatty degeneration
and softening, thus rendering the patient incurable."
Although, as we perceive, these two eminent pathologists do
not entirely agree as to all the causes of epilepsy, yet there is a
considerable correspondence in their views as to the different
steps of the process which constitute a paroxysm ; and we may
fairly assume that, if we have not arrived at the whole truth,
we are at all events approaching the solution of what has
been long regarded as one of the most inscrutable maladies
which afflict our race, called of old the morhus sacer, as being
a direct manifestation of demoniac power, and requiring nothing
short of miraculous intervention to deliver its miserable sub-
ject from the mysterious and malignant influence which held
it in possession. Now that the mystery is so far solved, we
may hope that more enlightened therapeutics may enable us
to achieve greater triumphs over this terrible malady ; but I
must reserve for my next lecture a consideration of this part
of the subject.
183
CASES TREATED WITH HIGH DILUTIONS.
By S. Teldham, Esq., Surgeon to the Hospital
The question of the positive and comparative efficacy of the
high dilutions of medicines has for some time occupied a good
deal of the attention of liomoeopatliic practitionei-s. Any-
thing tending, in however slight a degree, to the solution of
this question, cannot fail to interest the profession. Clearly, it
can only be solved by the careful obsen^ation and publication of
clinical facts ; and it is manifest, for reasons which need not
be particularised, that no place is so well calculated for eliciting
those facts as the wards of a hospital. Actuig under this con-
viction, the writer has commenced a course of exijeriments with
the patients under his care in the Hospital. The plan adoptedi
thus far, has been to conmience with the 200th dilution, and to
continue it as long as the welfare of the patients seems to
justify such a course — i. e. until that dilution has had a fair
trial, and has failed in producing the expected results. The
200th dilution has been selected as being a fair medium stage
in the scale of high dilutions, and because it would seem to be
the one much relied on by those who use the high potencies.
The writer is anxious, in this matter, to hold the place of an
impartial inquirer ; and, in order that he may not influence tlie
opinions of others, he purposely withholds his own impressions
and restricts himself, for the present, simply to a detail of the
cases as they are recorded by the house surgeon.
The first batch of cases is now presented to the reader,
and, if this inquiry is continued, others will, from time to time,
be published.
It should be stated that the medicines employed are pre-
pared by Messrs. Leath and Boss, the Chemists to the Hospital.
Case 1.
Sore Throat — Anna Stevens, aged 14, admitted October
Ist, discharged October 18th. Of a strumous constitution.
Two years ago caught cold, had sore throat, and has been
affected with it ever since. The tonsils are very much enlarged^
184 Cases treated with High Dilutions.
evidently chronically so — they nearly meet and fill the isthmus
faucium, and greatly impede deglutition. She has a very
peculiar blowing or barking cough — or rather, a spasmodic
expiration, which seems to be associated with the state of the
throat. Her general health is good. The house surgeon pre-
scribed Acom'te 3 and Mercurius 3 alternately every second hour.
From the 3rd, on which day I visited her, until the 7th, she
had Saccharum lactis. At the latter date she is reported as
having less inflanmiation of the tonsils, and as having lost the
peculiar expiration above described ; but she complains of pain
in the abdomen and has no appetite.
Pulsatilla 200, a drop ter die.
Oct. 9. — The pain continues, and is of a shooting kind.
Mercurius Corrosiv. 200, a drop ter die.
Oct. 12. — The pain in the abdomen has disappeared, but she
complains again of the pain in the throat.
Hepar Sulphuris 200 : ter die.
Oct. 14. — A recurrence of pain in the abdomen, with sour
taste in the mouth of a morning.
Mercurius Corrosiv. 200 : ter die.
Oct. 16. — No pain. Feels quite well.
Case 2.
George Carle, aged 37, rheumatism. Admitted October 7;
discharged October 19.
On admission says : — He got wet a fortnight ago on going to
work, and worked in his wet clothes all day. In the evening he
was seized with pain across the shoulders, and in all his limbs.
Since then he has been getting gradually worse ; he has now
pain in all the joints, but more especially in the ankles and the
great toes : these joints are swollen, tender to the touch, and
painful on movement. He has profuse perspirations. Pulse
86, skin cool; tongue clean; bowels rather costive. Sleep
much disturbed by the pains in his joints, which are worse at
night. Heart sounds, normal.
Aconite 200, a drop every four hours.
By Mr, YMham. 185
Oct. 5th. — Better, except in the feet, ^vhere the pains are
woise.
Continue Aconite 200.
Oct. Vth. — ^Is worse; pains in feet more acute. Had a
sleepless night Pulse 90.
Bryonia 200, a drop every three hours.
Oct. 9tL — Feels better. Pain almost gone from the right
foot, and is now confined to the dorsum of the left foot, which
is tender and swollen ; skin cool. Pulse 80.
Continue Bryonia 200.
Oct. 12th. — Pain in left foot easier, except when attempting
to put it to the ground. No pain last night.
Continue Bryonia 200.
Oct. 16th. — Much better in every respect. Is up and dressed,
and can stand without much difficulty.
Continue Bryonia 200.
Oct. 19tL — ^Well. Discharged.
Case 3.
Mary Foot, aged 40, sore throat. Admitted October 2 ; dis-
charged October 20.
In April had rheumatic fever, and has not felt well since.
On Sunday fortnight was seized with cold in the head, from
sitting in a draught. Two days after she was laid up with
bronchitis, and has been ill with it since.
On admission, she complains of aching all over ; cough of a
fotiguing character all day, with dyspnoea ; dull aching pain
between the shoulders ; throat sore ; tonsils inflamed, swollen,
and ulcerated ; deglutition painful ; pulse quick ; no appetite ;
thirsty ; respiratory sounds normal.
Aconite 200, a drop every four hours.
Oct. 4th. — Pulse 100; had sleepless night, from pain in
throat ; cough looser ; less pain between shoulders.
Continue Aconite 200.
Oct. 5th. — Pulse 90; restless night; tongue foul; tonsils
free of ulceration, but stiU red and inflamed.
Belladonna 200, a drop every four hours.
186 CoMS treated with High Dilutions,
Oct. 7th. — Had rather better night ; to-day throat more
painful, and deglutition more difficult.
Hepar Sulphuris 200, every four hours.
Oct. 9th. — Throat better ; less pain after swallowing.
Continue.
Oct. 12th. — Much better; throat well; has pain from
epigastrium to back ; worse after food ; tongue white.
Pulsatilla 200, a drop ter die.
Oct. 14th. — Pain greatly mitigated, felt only occasionally.
Continue.
Oct. 19th. — Well, as regards the foregoing attack; has
swollen knees from chronic rheumatism.
Ehus Tox 200, ter die.
Oct. 25th. — Discharged well; with the exception of the
knee pains.
Case 4.
Edward Dunn, aged 4 7, impetigo. Admitted October 5th ;
discharged October 25th.
About a month since an eruption appeared on the outer
side of the right arm, and on both feet and legs. It is of an
impetiginous character, scabby, mealy, rough, red, and raised
on an inflamed base ; it itches.
Ehus Tox, 200, ter die.
Oct. 13th. — The scabs cleared off the arm. The eruption
looks much better, and itches less.
Continue.
Oct. 19tL — Continues to improve; arm almost well; feet a
little swollen.
Continue.
Oct. 26th. — Has been progressing favourably, but to-day
there is a little more roughness and redness on the arm. The
other parts that were affected are quite well.
Sulphur 200, ter die.
Oct. 28th. — ^Discharged cured.
By Mr, Yeldliam, 1S7
Case 5.
Jane Bonnar, aged 52, gastric irritation. Admitted Octo-
ber 22nd ; discharged November lOtli.
Was in Marylebone Infinuary for bronchitis for six montlis.
She left in May. Since then has been badly housed and fed.
Three weeks ago was seized witli pain in stoniacli, and vomiting,
which has continued ever since. Slie vomits cventhinj' alK)ut
a (j[Tiarter of an hour after taking it ; the ejected matter being
sour and bitter, and green looking. Has great pain in tlie
stomach after taking food, and the epigastrium is very tender
to touch. Anorexia ; thirst violent ; headache woi-se at night ;
has a little cough ; bowels costive.
Since the vomiting commenced she has been living in a
house where the sewers were open, and painting was going on.
Tinct. Aconite 200, ter die.
Oct. 26th. — Has not vomited since beginning the medicine.
Exquisite tenderness in cardiac region on pressure ; pulse
hard and incompressible.
Continue Aconite 200.
Oct. 3 0th. — ^The previous symptoms have disappeared. There
is catching pain under the lower ribs of the left side, shooting
up the breast ; worse in breathing and movement.
Bryonia 200, a drop every four hours.
Nov. 2nd. — ^Well, except weak ; takes and enjoys food.
Nov. 4th. — Saccharum lactis.
Nov. 10th. — Discharged cured.
Case 6.
Jane Staines, aged 50, hepatic irritation. Single, a cook.
Admitted October 22nd; discharged November 4th.
Thirteen days ago was seized with vomiting. Her ejecta
were composed of " blood and matter." Some hours after the
vomiting, was seized with pain in the region of the liver, which
has continued ever since.
On admission, complains of dull pain in right hypochon-
dricun, worse after movement. If she moves, has sharp, shoot-
ing pain through the side ; headache ; pain in temples ; heavi^
188 Cases hy Dr. Drury,
ness over the eyes ; appetite fair ; tongue slightly coated ;
bowels have been kept open by purgatives. Probably had
calomel from her medical attendant. The mouth feels sore ; is
blistered, and there is a slight mercurial foetor ; very weak and
prostrated; pulse 84; skin cooL On percussion, the liver
does not seem enlarged, but is tender on pressure ; stools are
generally dark-coloured; has large, foul, chronic ulcers on
both legs. Twenty years ago had jaundice.
Bryonia 200, a drop ter die.
Oct. 26th. — Much the same.
Aconite 200, ter die.
Oct. 28th. — Better altogether; pain in side much better,
but still there.
Continue Aconite 200. The ulcers on the leg to be poulticed.
Oct. 30th. — ^Altogether much better; no tenderness on
pressure in region of the liver ; tongue clean ; no thirst ; pulse
normal.
Nov. 2. — Continues to improve ; general health pretty good ;
ulcers healing well.
Saccharum lactis.
Nov. 4th. — Quite well, except the legs, which are granu-
lating healthily and rapidly. Wishes to go home. Dis-
charged.
CASES BY WILLIAM V. DEUEY, M.D., M.E.LA.
Physician Accoucheue to the Hospital.
Case 1.
Dysmenorrhcea, — J. F., a servant, aged 24, admitted as out-
patient July 12, 1863.
Has been out of health for the last three months ; menstrua-
tion returns every five or six weeks. The quantity is large, and
is passed in clots ; suffers during the period from bearing down
pain ; complains also of pain in head, with pressure in eyes ;
also pain below ribs, increased by stooping, believed to be
flatulent.
CaSMhyDr.Ih'ury, 189
Sepia 30 in solution twice a day for three days;
then to stop three days, and repeat.
July 26tL — Feels better, but still feels the pain below ribs.
China 6-30, I twice a day.
Aug. 1 Bth. — Called to report liei'self well.
Case 2.
Change of Lift, — Louisa D., age 44, admitted as out-patient
June 28th, 1859. Complains of violent pains in back of
head. Vertigo aggravated by movement. This is of daily occur-
zence: the pain in head is a heavy bruised pain. Menstniation
stops for two or three months : about a month ago menses were
present ; they had continued on and ofif for five or six weeks.
Lachesis 6-30, \ twice a day ; Pulv. ij.
July 5th. — ^Much better, slight giddiness, but weight in back
of head and neck is nearly gone.
Lachesis 6-30, \ twice a day ; Pulv. ij.
Omit medicine if better.
July 12th. — Omitted medicine when she felt better, but re-
sumed it again, as there was some return of headache ; and
again obtained relief.
Continue Lachesis.
July 26th. — Is now generally better, had omitted the medi-
cine for four days, but resumed it again on feeling some return
of headache.
To continue Lachesis if any return of symptoms.
Case 3.
Headaches, Jkc; scanty menstruation. — C. M., age 36. Mar-
ried, has two children; youngest 12. Admitted as out-patient
July 5, 1859. Suffers from headache before and during men-
struation ; there is vomiting and pain at the period. Suffers
from debility. Complains of pain under left ribs. Constipa-
tion. Menstruation scanty, often absent.
Pulsatilla 6-30, J twice a day;
stop three days ; repeat twice.
July 26th. — Burning pain over eyes. Sour risings. Beating
in head. Bloated feeling after food.
190 Cases ly Dr. Drury,
China 6-30, 9 3 a day. Pulv. iij ; discontinue if better.
Aug. 16th. — At first much relieved, but on stopping me-
dicine some return of symptoms.
Eept. China.
Sept. 13th. — Improving.
Phos. Acid 7-20, \ 3 a day. Pulv. ij.
To be followed by China.
Case 4.
Cerebral disturbance. Convulsions. — Eachael S , aged one
year and six months, admitted as out-patient July 19, 1859.
Five or six weeks ago had convulsions ; during fit, and while
it is threatening, right hand is contracted. Cheeks flush, then
get pale, child trembles.
BeU. 6-30,j3aday.
July 26th. — Nights very restless; screams out suddenly at
night ; sleeps with eyes partially open.
Bell. 6-30, I 3 a day. Pulv.ij.
Aug. 9. — Much better;, perspires very much about head;
:jontinues to get thin.
Acid Phos. 30, J three times a day, six days.
Aug. 30th. — Child is all but well; is still, however, weak.
Calc. Carb. 30, J three times a day.
Case 5.
Diarrhoea after food. — ^Amelia H , age 1, admitted as
out-patient July 26, 1859.
A weak and sickly-looking child ; has had diarrhoea for three
weeks; has had thrush for nine days; evacuations are dark
green, and are generally passed after taking food, which also seems
to produce pain.
Ferrum 6-30, \ every four hours. Pulv. y.
This was followed by Calcarea Carb. 6-30, i 3 a day. Some
more Ferrum was given.
Aug. 2nd. — Improving; takes her food well; has pain in
stomach at night.
Gale. Garb. 6-30, J 3 a day.
Cases hy Dr. Drury. J 91
Aug. 9th. — Much better, but Iiad some diarrlura throuyli the
week; the evacuations have been sour, grei*iii.sli antl white ; hist
two rather better.
Cham. 30, thrco times ii <lay.
Aug. 16th. — Improving. Takes her fond well; but bowels
still show a tendency to act after taking it.
Ferrum 30, three times a day.
Aug. 30th. — Child is reported well ; looks vciy much better;
is getting fatter and stronger.
Case G.
Eczema. — Eliza T., age 68, admitted as out-patient July
26th, 1859. Has suflfered more or less for years from ill
health, but for last three months has suflered much from an
erythematous patch of about ten inches in length on left leg.
There is much itching. There are also red patches on fingers,
with purulent vesicular eruptions. She has herself taken
Shus, Aeon, and Belladonna. She has a wet rag on leg.
Phos. 6-30, 6 twice a day. Continue.
Aug. 9. — Eather better, forefinger of right hand is bright
red and suppurating over knuckle. The itching varies.
Continue Phos. 30, twice a day.
Aug. 23rd. — Improving.
Continue Phos. ; but to stop every alternate three days.
Sept. 13th. — Improving, but has a few spots on the right leg :
the eruption seems to get more round left leg.
Continue Phos.
Oct. 4tL — Improving, still much itching, stiU uses the
wet rag to leg.
Continue Phos.
Oct. 25th. — Continues to improve steadily.
Case 7.
Ba/iMda, — ^Louisa W., age 28. Admitted as out-patient
July 5, 1859. States that about six months ago she noticed
a swelling in mouth between tongue and lower jaw. Continuing
192 Cases hy Dr. Ih^ry,
to increase in size, she sought allopathic advice. The tumour
was opened and burned with caustic, without effecting a cure.
It is now about the size of a small walnut. Her health has
been moderately good, except for some leucorrhoea, attended
with smarting ; and that she suffers from pain the first day of
menstruation.
Carbo Vegetabilis 2-30 daily for six days ; stop three ;
then repeat.
July 12th. — She comes sooner than expected, as she says
the swelling is larger, and she feels sick, and trembles.
Aut. Crud. 6-30, \ 3 a day.
This was followed by Carbo AnimaKs 2-30, four doses.
July 26 th. — Swelling has increased in size.
Mercurius 6-30, J 3 a day.
This treatment was continued till September 13, without any
apparent change ; but as she was suffering from pain during
menstruation, she was given Pulsatilla 30.
After this she had Thuja, Ehus, and then Mercurius 4-200,
3 daily ; stop three days and repeat.
Nov. 22nd. — Eanula smaller, nausea, wheezing breathing,
soreness in chest, and hoarseness.
Hep. Sulph. 9-30, /o 3 a day; Pulv. ij.
Nov. 29th. — Chest better, but is suffering from headache.
Kahnia 30.
March 13th. — ^The tumour has continued to decrease in
size, and is now about the size of a pea.
The attendance at the Hospital had ceased from November
to the following March ; but the improvement that appeared to
have commenced under Mercurius 200, steadily continued, and
by April 24th all trace of ranula was gone.
These cases have been selected more from their being some
of the earliest in the case-book, than from any special interest
attaching to them ; they are rather imperfect in detail, as the
notes were taken more for the sake of reference to the medi-
cines given, than with a view to their publication.
A CASE OF EXTRA-UTEBINE GEST^\ riOX.
Bt Mr. Leadam.
Mb. Pbesident,
I bring the following case before tlie British Ilomojo-
pathic Society, in the hope that it may be considei-ed worthy of
being recorded in its transactions, as one of those rare casos
which give additional interest to the study of gestation, as well
in its abnormal as its normal progress. Such cases are instances
of the natural history of disease, and are at all times instruc-
tive, if not remediable. They are aids to diagnosis in other
obscure and diflBlcult cases, and indicate the eflforts nature in-
stinctively makes to restore the equilibrium of the natural
processes, when accident or injury has disturbed them. Again,
they excite a great amount of reflection upon the means
which it might be possible to adopt in similar cases, with the
hope of releasing the mother and the child. The members of
the Society will, I am sure, not be slow to appreciate any
advantage which the recording of such a case may bring.
I esteem it a fortunate circumstance, that in a case of such
rare occurrence, and of such an abnormal and complicated
character, I should have the testimony of two highly-respected
members of this Society, as to the correctness of the descrip-
tion I have given of the case. The lady was a patient of the
President's, to whom she was known from her earliest child-
hood, and also to Mr. Cameron, who, at various periods had
attended her when Dr. Quin was ill or absent from home.
Mr. Cameron was also present with the eminent physician-
accoucheur, and professor of obstetrics, and his son, who had
VOL. ni. 13
194 Mr, Leadam on Extra-Uterine Gestation.
been several times consulted at the post-mortem examination,
which was performed by Mr. Eobinson, at that time house sur-
geon to this Hospital. My professional services were engaged
by Dr. Quin for the period of accouchement; but several
unusual symptoms showing themselves before the time of
parturition, Dr. Quin became desirous that an examination
should take place, and he finally associated me with himself
in the conduct of the case, and I had thus the advantage of
his counsel and co-operation in the treatment of this interesting
case, in which the most complicated disturbances arose at
different times, in various organs, from excessive sympathetic
irritation during the progress of the latter months of the gesta-
tion. The following history wiU show the progress of the case.
H. M., aged 32, had been for some time in indifferent health
previous to July, 1862, the catamenia then appeared, and ter-
minated on the 12th of that montL At the end of July, she
thought herself pregnant from the similarity of her sensations
to those at the commencement of former pregnancies. Had been
married eight years, and had several miscarriages, and once a six
months pregnancy, five years ago. On the 10th of August, the
catamenia were due, but did not appear. About this time, when
driving a pair of ponies in the country, they took fright, ran
away, and although the pony-carriage was dragged into a ditch,
she was not thrown out, but shaken about and frightened. A
slight haemorrhage occurred per vaginam, for which she was
confined to the sofa. Early in December quickening was
said to be felt, and occasionally, after that, for two months,
gentle but distinct movement was noticed. Before this, how-
ever, attacks of flatulent colic were experienced. In conse-
quence of the troublesome persistence of these, she came up
to London, in order to be under the care of Dr. Quin, and as
an occasional flow per vaginam took place, she was confined to
the sofa.
On January 27, I first saw the patient with Mr. Cameron,
and made the following report : — " The patient is in constant
Mr. Leadamon Extra-Uterine Gestation 195
dread of miscarriage, haa occasional flow per vnginam on
any exertion or incautious movcmcut innw tlic sufii. Has
repeated attacks of flatulent colic. Eats mcII. The ahdu-
men is enlarged to rather less than its usual size at this
period of pr^nancy, but the eulargeinent is not central and
ovoid as it should be, but chiefly on the left side, extend-
ing to the umbilicus, beyond which, to the right side there is
nnnsnal resonance. The patient thinks she fuels occasionally
slight foetal movement, but it is very gentle. The nioveniont
is not perceptible to any other person. The bowels are kept
open by a teaspoonful of castor oil taken every other day.
The evacuations are large." In Felmiary the same conditions
existed, but there was increase of size; some tenderness on
firm pressure, and slight movement was felt by the medical
attendant but only once. I thought I had discovered a sub-
dued placental briiit once or twice thi'ough the stethescope,
but the foetal heart was not distinguished. Dr. Quin having
charge of the case, asked me to see her again in March, when
some sanguinolent discharge per vaginam took place, of
a grumous character, and which continued for a week. It
appeared to result from a sudden impulsive movement in rising
to greet a visitor. At this period unduly large evacuations
were passing from the bowels, of a normal consistence and
appearance. The abdomen ceased to enlarge, but flatulent dis-
tress increased ; the urine was loaded with lateritious deposit ;
the appetite variable ; there was midue hardness of the abdo-
men, and the outline of a fcetus was diagnosed once or twice
when the colon was less distended with air, wliich at other times
obscured it The entire colon seemed enormously distended with
air, and its transverse portion was very tender. There were
frequent eructations, and the appolito n)oro fanciful. At the
end of this month the alvine evacuations continued wonderfully
large in quantity, but not at all of the nature of diarrlicea.
April 3rA — Good Friday. — Eat some salt fish which dis-
agreed, and produced a violent attack of flatulent colic. The
13*
196 Mr, Leddam on Extra-UteHne Oestation.
stomach contiilued in a state of great irritability for three
weeks, with great general distress from colics, sleeplessness and
febrile exacerbations at night, for which aconite was given.
The treatment for the foregoing conditions was according to
the symptoms. Niuc Vomica for the flatulency; Pulsatilla,
Belladonna^ HyoscyamuSy Yeratrwm, Sdhina, Con/mm, for the
grumons discharge and pain in the left ovarian region, &c.
On the 10th of April, one of the physician-accoucheurs
formerly referred to, saw the patient, and gave his opinion, that
however great the sufferings were from these sympathetic symp-
toms, it would be better to wait the normal period of pregnancy
without interference. There was, at that time, a grumous, dark,
and occasionally red discharge per vaginam on and off for two or
three weeks. The symptoms of gastric irritation continued, as
well as the tenderness of abdomen, of the left side chiefly, and
the tympanitic distention, flatulent colics, &c. The urine was
often deep coloured and turbid, loaded with a brick-dust sedi-
ment. Solid food was refused; chicken panada and soups
with seltzer water and champagne formed the chief diet.
On the 7th of May, the full time of pregnancy had expired.
A careful exploration of the uterus was made. The os uteri
was found very high up, but by great effort it was reached, and
found patulous and relaxed, but the inner os closed. The sound,
carefully used entered the uterus, but on attempting to turn it
a resistance was felt. The attempt was inunediately discontinued.
There was at this time milk in the breasts, which by pressure
appeared at the nipples. On the 9th of May, the other
physician-accoucheur saw the case. After a careful examination,
he declined to give a positive opinion till after another visit.
On the 11th of May, he saw the patient again with me.
At this time it was distressing to her to lie on either side : it
always produced an attack of flatulent colic. The case was
very dark, no one could say what was the real state of things ;
there were symptoms of pregnancy, but no child could be
felt in the uterus. Air in the intestines seemed to predominate,
yet there was a solid mass beneath the air occupying the left
Mr, Leadam on Extra-Uterine Oestation. 197
side of the abdomen. The countenance ^ras mucli fallen away
and exhibited great distress — general attenuation. She wixs
unable to bear more than just to be earned from the bed to the
80& Sickness was now frequent, the bowels irregular, and a
persistent febrile condition.
After this examination, on the next day there was an accession
of inflammatory fever — ^the skin burning hot Incn*asod thirst
and tenderness of the abdomen; the hands burning, pulse 120.
Exacerbations at night, sleeplessness and a diarrhoea set in
of blacky offensive, at times sanguinolent, and putrescent evacua-
tions. This lasted a fortnight, during which great exhaustion
occnnedy and the evacuations appeared mixed with albuminous
and membranous fibres, but so intermingled and so offensive
that the nurse would not separate them. I saw them at times,
but could not well get hold of the matters by the pieces of stick
which I used. At the end of a fortnight, about four inches of
a cord-like tubular structure was passed, as weU as a buucli of
firinge-like matter. These were washed and taken to St. George's
Hospital Museum, and there submitted to the microscope,
and declared to he intestinal cast and a mass of hlood vessels.
After this, the evacuations became more natural, of a pale brown
colour, and the diarrhoea ceased. One teaspoonful of castor oil
was given, with a view to the expulsion of any more of the
membranous matters there might be, and of some of the air
from the intestines. It caused sickness and increased exhaus-
tion, but brought nothing abnormal away.
It was at this time suggested by me that the tubular portion
which had come away was a part of the umbilical cord, and the
fiinge-like tissue a part of foetal placenta, and that an ulceration
of the intestine had occurred in connection with the cyst through
which these had passed. This opinion was not coincided with
by the phymcian-accoucheur who attended along with me,
for he thought she must have died long ago if such had been
the casa After this the abdomen diminished in size, much
air having passed, as well as liquid evacuations. Ten days
198 Mr, Lecidam on Extra-Uterine Gestation.
after, the nurse observed sometliing protruding at the anus
after evacuation, which receded into the bowel again. The finger
was passed into the rectum as high up as possible, but it could
not be found. In two days more a long piece of the same tubular
structure was passed, resembling umbilical cord. The physician-
accoucher visited the patient, but did not agree in this view. It
was thought now that some fluctuation was felt in the abdomen,
but it was indistinct. At times the tumour could be felt more
defined and hard in the left side, but at other times it was obscured
by the tympanitic distension. After this the symptoms became
more and more grave, the vomitings more incessant, gradual ex-
haustion set in, but no diarrhoea; there was sleeplessness and
distress, and death happened on the 17th of June, two months
after the full term of gestation was completed. The case was
watched throughout by Dr. Quin, and was seen at times by Mr.
Cameron at the early stages.
Post'Mortem Examination. — Great emaciation of the face and
extremities. The abdominal parietes, however, contained thick
layers of adipose tissue. On making a crucial incision at the
umbilicus some pus was observed in the fossa and beneath it.
(During life the nurse had observed a mattery discharge from
the umbilicus.) On raising the peritoneal flaps of the left side
we found the body of a female child, packed very close in a
curvilinear form, with the head lying upwards and outwards,
the back towards the left outline of the mother, just at the
crista ilei. It was of the size of an average foetus of six or
seven months, and lay in a sac formed by thickened peritoneum
and amnion united, aU matted in with the abdominal parietes.
The foetus was covered by the usual caseous deposit ; on lifting
it up from this bed, the umbilical cord was found broken, but
resting at the aperture of a large ulcerated opening in the sigmoid
flexure of the colon. It corresponded with the portions of
tubular structure which had passed fmm the bowels. The foetus
was in a state of white putrescence, very offensive, but firm,
and tightly compressed, of a drab colour, the limbs indented
Mr. Leadam an ExtrorUttriiu Oestatim, 199
one with the other. Through the ulcerated opening in the bo\i'el
fSoeculent matter had entered the sac, the edges of the opening
were thickened. The sac was adherent to the intestines on its
posterior aspect, and the odour was highly putrescent. The
foetal placenta would seem to have been adherent to the in-
teatineB, and decomposing to have caused inflammation and
ulceration into the bowel, through which it and the portions of
cord first found had exit, and thus accounting for the putrescent
diarrhoea. On raising the foetus in order to remove it, no attach-
ment existed. There was no fluid in the sac, for, on the day of
death a quantity had issued per rectum and saturated the bed.
The uterus was a little larger than normal and of a dark purplish
colour. The fallopian tube was identified at its junction with
the uterus, but terminated in the thickened tissue matted
together. The foetus was taken to St. George's Hospital, but
was thought too putrescent for any further examination, and was
thrown away before Hospital visit next morning.
The preceding case appears to differ from the greater number
of cases of extra uterine gestation which are recorded, in the
fiEulure of any natural effort to get rid of the foetus, or to pre-
serve it from putrescence. It will have been observed in the
course of the history that the sympathetic irritation induced in
the mother was evoked at an early date, and that what might
be called the conservative effort to dislodge it from its abnormal
position took place posteriorly, or in the bowel, and therefore at
a point which, whilst of necessity it must prove fatal to the
mother, equally precluded the possibility of any surgical assist-
ance. The ulcerative process which took place in the intestines
of course admitted the intestinal gases into the sac, and to this
cause alone is attributable the putrescency of the foetus, which
so long as it was encased and hermetically sealed in the cyst
would remain for any length of time free from septic influ-
ences. There are many cases of this accident scattered through
the transactions of the difierent medical societies, but in the
44th voL of the " Medico-Chicurgical Transactions " is to be
200 Mr, Leadam on Extra-Uterine Gestation.
found a very interesting account of one case upon which Mr.
Adams, of the London Hospital, operated with success in con-
junction with Dr. Kamsbotham, and some part of its details will
I doubt not be interesting to the Society.
In the Museum of the Eoyal College of Surgeons there are
only five specimens of extra-uterine foetation, and from these
and others recorded it would appear that the fallopian tube is
usually the seat of the accident, and not the ovary.
One of these is the case alluded to which occurred in 1860.
A patieut was taken into the London Hospital under Dr.
Eamsbotham, with a large abdominal swelling, which Dr. Rams-
botham and Mr. Adams considered to be an extra-uterine foetus.
" M. S., set. 28, of fair complexion and middle height, and with
all the appearances ofgood health, had been married eight years.
She had always menstruated at regular periods, but had never
been pregnant before. In January, 1859, she menstruated very
profusely, and very scantily in February. From March until
May she was subject to occasional attacks of severe cramp-like
pains, which were confined to the right side of the abdomen,
extending from the pelvis to the hypochondrium;- she felt very
sick, but rarely vomited ; she had no distinct morning sickness
at any time. After February her menstrual secretion stopped,
and she dated the commencement of her pregnancy from the
early part of this month. In June she first felt the move-
ments of a child, and her breasts perceptibly enlarged. This
condition continued, and after some time she observed milk
escaping from both breasts, more particularly the left, and the
veins of the left leg and thigh became varicose.
" She continued in good health, her abdomen increased in size,
and she distinctly felt the movements of the child until the
30 th, a day or two prior to which she had a heavy fall, which
was followed by soreness and cramp down to her knees. She
considered herself in the ninth month of pregnancy, and ex-
pected her confinement in the early part of November. She
was visited by Mr. Williams, surgeon, of Plaistov, Essex. On
Mr. Leadam an Extra-Uimru Oestation, 201
the 30th of October she leceiyed a severe mental shock from
her sistei'a death At this time she ceased entirely to feel the
moyements of the child, and a week after this she began to feel
sleepy, tired, and worn, and suffered from a sense of stifihess in
her limbs, but had no distinct pains like uterine pains. A
discharge took place from the vagina, and blood varying in
colour &om dark to pink, and pieces of flesh-like substances,
entirely inoflfensive in odour, were expelled in gushes. She
reckoned her time of gestation to have terminated at the be-
ginnlng of November. From this time she gradually diminished
in siza
"In January, 1860, she remained in much the same state.
In February, menstruation recommenced, and it has continued
r^^larly ever since, varying in quantities, and usually ex-
pelled in gushes. The milk remained in her breasts until
March Latterly she had become much thinner. On ex-
amination a hard oval tumour was felt, particularly on the
right side of the abdomen, extending from above the umbilicus
to the right side of the symphisis pubis. There was a re-
markable prominence in the tumour, which was quite irre-
znoveable, and very unlike any swelling from a fibrous tumour
connected with the uterus. The hand could be easily passed
around the greater part of it, and the abdominal parietes could
be made to glide over its anterior surface. There was a feeling
of irregularity about it ; but the individual portions of a foetus
could not be recognised distinctly, for there was a good deal of
subcutaneous fet in the walls of the abdomen. There was no
pain on pressure. The uterus was found by examination per
vaginam, to be rather higher than usual, but there was no
evidence of disease in it. She was able to perform her usual
domestic duties, and expressed herself very anxious for the
removal of the tumour. There could be little or no doubt as
to the precise nature of the case ; so Dr. Eamsbotham and Mr.
Adams agreed that the operation of gastrotomy should be per-
formed, but thought it prudent to allow six months from the
202 Mr, Leadam on Extra-Uterine CfestaOon.
end of what was supposed to be the natural term of gestation
to elapse. She was therefore re-admitted in May, and being
then in perfect health, and fully alive to the risk of the opera-
tion, it was performed by Mr. Adams on the 31st.
I avoid the minute details of the operation. " On opening
the peritoneum (five inches in length), the surface of the
tumour presented a glistening aspect, and was only slightly ad-
herent at the part. The cyst, which was four lines in thickness
and very firm, was opened, and a pint of a greenish-yellow
transparent fluid escaped, with yellowish flakes of vemix caseosa
and some hairs. As soon as the cyst was opened, a loop of
the funis protruded. The cyst was divided on the finger, to
the extent of the opening in the abdomen, and the funis being
returned, and a portion of the rectus muscle divided trans-
versely, I felt the head and body of a foetus, with its head
uppermost, and its face towards the spine. I introduced my
hand and seized -an arm, which I pushed back, and then had
no difficulty, owing to its limp state, in extracting the foetus
by the breech. The funis was divided so as to leave about
two inches outside the incision. On traction by the remaining
part of the funis, it was clearly ascertained that the placenta
was firmly adherent, and, under the advice of Dr. Eamsbotham
no attempts were made to remove it. A piece of omentum
which had escaped through the opening was cut away, and
some rather large arteries, as well as some vessels in the cut
edges of the cyst, were secured. I carefully sponged out aD
the fluid from the cyst, the walls of which collapsed, especially
on the left side. Firm adhesions seemed to keep the right side
in contact with the abdominal walls. The edges of tho wound
were carefully brought together by interrupted sutures, carried
only through the integument and subjacent fSat, and all the
parts were kept in apposition by careful strapping, padding with
cotton wool and an elastic bandage. After the operation she
became extremely fidnt, but was restored by brandy. She went
on uninterruptedly well. The funis, which on its first appear-
Mr. Leadam on Extra-Utrine Oestatian, 203
ance daring the operation, was thick and oedematons, shrivelled
np, and was altogether lost sight of on the fifth day after the
operation ; no doubt it escaped among the discharges. There
remained for some time a small fistulous opening with ex-
uberant granulations, &c.
" With respect to the child : — ^The length of the child was two
feet, the weight was four pounds three ounces. The urachus
and umbilical vessels were open. The child was a female well
developed. The cuticle peeled off in large flakes ; there was
no offensive odour. The head was well covered with fine, long,
and light brown hair ; the nails were long and well developed.
The parietal bones were slightly displaced, and overlapped by
the occipital and frontal bones. Both comiae were opaque, the
eyes shrunk. No vitreous humour was found.
" No opportunity was afforded in this case of proving the
precise situation of the extra-uterine foetus. Whether it was
developed in the walls of the uterus or in the abdominal cavity
by attachment of the ovum to the peritoneal surface of the
intestines, could not be made out."
The second specimen in the College Museum is that of a
woman aged thirty-six (having one child), who in the fourth
month of pregnancy was reaping in a com field, and carrying a
heavy burden, when she fainted, and was carried home ; faint-
ness, but little pain ensued, and she died the next day. The
middle portion of the left fallopian tube was dUated into an
oval cyst filled with coagulated blood. In the anterior wall is
a ragged opening, through which the foetus had burst, and had
escaped, and is seen falling through into the pelvis, which was
found full of blood coagulated. The uterus was enlarged as in
the early stages of pregnancy, and was said to have had, when
recent, a deciduous membrane ; the os uteri was closed by a
gelatinous exudation.
The third case shows the right fallopian tube dilated into a
BBC, about one inch and a-half in diameter near to its extremity,
and opened, to show a small foetus (six or eight weeks) budding.
204 Mr, Leadam on Extra-Uterine Oestation.
the face distinct, and the extremities just evolving. There is
no increased vascularity in the uterus.
The fourth case is the section of a full-sized foetus, which
after arriving at maturity, had been retained over fifty-two years
in utero, enclosed in a sac, which had become ossified. The
foetus was roUed up and compressed into a firm globular mass.
The parts of the foetus which lay external or towards the sur-
face of the cyst, became absorbed down to the bone, while the
muscles, &c., situated towards the interior, were soft and natural
After aU these years the limbs were partially unfolded, and
there were no signs of decomposition.
The fifth case is that of a condensed and ossified foetus, which
had been retained in the abdomen fourteen years beyond the
ordinary period of gestation. It was in a museum in Ham-
burg before it was brought to the College of Surgeons.
The foetus is almost completely developed, but compressed
and dried, so that little more than the bones remain to indicate
its previous form. It is reduced to a flattened irregular mass,
about four inches long, by from two to three inches wide.
The foetus was removed by operation, as was believed, from
the fallopian tube. The patient recovered, and lived a long
time after in Hamburg.
Dr. Wm. Campbell, of Edinburgh, in a memoir on extra-
uterine gestation, published in 1843, details nineteen cases in
which the foetus remained in the abdomen of the mother during
a period varying from two to fifty-six years, and he refers to
several cases in which the mothers so circumstanced conceived
once; two cases in which the mothers bore two children, four
cases in which three children were bom, two instances of five
birtlis, and one case where the mother gave birth to six children,
whilst an extra-uterine foetus remained in the abdomen.
However, he remarks, that " except in some rare cases, sooner
or later, in consequence of many causes, which may or may not
bo obvious, inflammation arises in the adjoining organs, in-
volving the envelope of the foetus." In those cases which have
Mr, Leadam on Extra-Uteriiu Oestatian. 205
remained innocent for so long a time, nature converts the cyst
contaimng the foetus into a material not readily acted on, which
constitutes a permanent covering, ossification of the cyst takes
plaxse, or the foetus undergoes a sort of petrifaction, by which it
is converted into cartilage or bone, and is materially reduced in
voluma
Numerous instances are on record where the foetus has been
got rid of by ulceration into the vagina, rectum, colon, bladder,
as well as by abscess, opening externally, either at the umbilicus
or some other part, of the abdominal walls.
It is most probable that in all such cases, the decomposition
and subsequent disintegration of the foetus have preceded the
efforts of nature to evacuate the contents of the cyst; for
when the foetus has been extracted entire, however long a period
m&j have elapsed after the termination of natural gestation, no
decided evidences of putrefaction have been found. In a case
quoted by Dr. Eamsbotham (in his " Principles and Practice of
Obstetric Surgeiy "), where a foetus was removed by incision,
which had evidently remained eight years in the abdomen of
the mother, it was in " an astonishing state of preservation."
(The case is given in the Medico-Chirurgical Review for 1834.)
A fistulous opening was formed at the umbilicus, which was
enlarged, and the foetus removed. In another case referred to
by Mr. Adams, the patient declined an operation at the very
time when surgical interference was called for, and she died,
worn out by diarrhoea and hectic.
DISCUSSION.
Mr. Cameron. — ^The lady whose melancholy case Mr. Leadam
has so well described, was well known to me for many years, and
I frequently attended her when Dr. Quin (her physician from
her childhood) was ill or out of town. I was called to see her
on the 14th January, 1863, and continued in attendance during
the remainder of that month, during his absence in the country,
where he was detained by illness. Before he left London he had
arranged with the patient and her friends, that Mr. Leadam was
206 Mr. Leadam on Extra-Uterine Gestation.
to attend her in her accouchement, and, as some puzzling and
anomalous symptoms connected ifith her pregnancy showed
themselves, I obtained her consent to my having a consultation
with that gentleman, and accordingly we met on the 27th Janu-
ary. Two days afterwards. Dr. Quin returned to London, and I
ceased my attendance. From my interest in the patient and in
the case, I was able afterwards through conversations with Dr.
Quin and other friends, to watch the progress of the illness pretty
accurately, and from having been present with other medical
men at the post-mortem examination, I am in a position to bear
full testimony to the correctness of Mr. Leadam's report of the
case.
Dr. Druey had listened with much interest to the details of
Mr. Leadam's well reported and instructive case, one of a class
of cases more frequently heard of than seen, as from their great
rarity they were unknown to many practitioners except from
books ; Dr. Drury's own knowledge being gathered from such
sources he felt a hesitation about saying anything, but being ap-
pealed to by the President, he availed himseK of the opportunity
of thanking Mr. Leadam for having so faithfully preserved the
history of the case. He at the same time conamended the judg-
ment of the gentlemen in attendance that led them during the
life of the patient to form an opinion as to the nature of the case
which was afterwards borne out by post-mortem appearances.
In this particular case the question of obtaining relief by operative
interference may not have arisen, but in these days of bold and
successful operations, the medical attendant should always be alive
to the chances of saving life afforded by a timely and well-planned
operation. It unfortunately too often happened that the golden
opportunity was lost by a hesitancy about operating even where
such a step was inevitable if life was to be saved. At times
also this was deferred without sufficient reason, till the patient's
strengtli was so much reduced that the hopes of success were much
diminished. A case had arisen last year in Allopathic practice
that caused much controversy, but which helped to illustrate the
point that he. Dr. Drury, alluded to, it was that of a medical
man at Tunbridge Wells, suffering from obstruction of the in-
testinal canal, some of those who saw the case wished to practice
Amusset's operation, but others objected because there still some
small amount of foeces passed, so that there was not total obstruc-
tion; the non-interference men carried their point, and the patient
died ; now, in this case, had an operation been performed life
might have been prolonged for a year or two. In the cases im-
mediately imder consideration, even when their true nature was
recognized, no rule could be laid down for interference, as from
their known terminations the point could only be settled on the
Mr, Leadam on Extra-Uterine Gestation, 207
merits of each particular case. It sometimes happened where
extra^uterine foetationhad taken place that the immediate danger
passed over, and subsequent pregnancies tenuinating naturally
and favourably took placa A case occurred in the practice of Dr.
M. W. MiiUer, of Hohenweihr, where a hernial tumour was found
to increase in size as pregnancy went on, and which was ulti-
mately opened, the cmld and placenta being extracted, but
imliappily the patient sank from internal haemorrhage. Writers
generieJly classified extra-uterine foetation imder three heads,
ovarian, tubular, and interstitial, the tubular being the most
frequent In Mr. Leadam's case the mischief would appear to
have been connected with the ovary; it was a question how
txr the early history of the case threw a probable light on the
cause of the evil, for from the state of health, &c., prior to preg-
nancy, the pathological change most probably then took place,
pr^nancy being prevented following the ordinary course by what
nad existed for some time. Dr. Campbell had collected some
valuable statistics of this accident, showing that the foetus might
be retained without destroying life for a period varying from
months to many years. The nope of the foetus being expelled
either through the abdominal parieties or through the bowels,
was necessanly uncertain, but happening sufficiently often to give
hope when such an action was set up that it might terminate favour-
ably. The passing a portion of the umbilical cord was a first
effort in the present case towards a removal by the bpwels. Not
liaving experience of his own to relate Dr. Drury would not
trespass longer on the time of the Society.
The President, in bearing full testimony to the accuracy and
exactitude of the description of the sad, but extremely rare case
just read to the Society by Mr. Leadam, said, that the subject of
it, from her infancy up to the period of her marriage had, in all
the illnesses incidental to cluldhood and youth, been treated
Homoeopathically. On her marriage she removed from London,
and resided abroad for some years, and afterwards in the country,
and there being no Homoeopathic practitioner in the neighbour-
hood, she was generally treated Allopatliically, except occasionally,
while in London. Although several times pregnant, no child
was bom alive, — ^miscarriages each time having taken place early,
with one exception, about three years ago, when the child was
six months old. About a year and a-half before her last
pregnancy, of which they had just heard the history, she had a
very dangerous attack of diptheria ; this was followed a short
time after by ulceration of the womb, which was treated locally
by injections and cauterization, and internally by alteratives and
tonics, by the Allopathic physician-accoucheur then in attend-
208 Mr, Leadam on Extra-Uterine Oestation.
ance. To this succeeded ulceration of the rectum, which assumed
so serious a character, that an eminent surgeon was associated
with the above gentleman in the treatment of the case. Her
health deteriorated greatly, she became much emaciated, she
imderwent great pain and discomfort from the local treatment
pursued, which brought on two severe attacks of erysipelas, which
aggravated greatly the pains in the rectum. A highly nervous,
excitable, and irritable state supervened, accompanied by symp-
toms of a hectic character, and inability to move, sit upright, or
stand without suffering or violent paroxysms of pain in the
rectum. Her own family became alarmed and interfered, and her
earnest wish to return to the treatment she had been accustomed
to from her childhood, was acceded to by her husband and his
family, and he (Dr. Quin) was sent for. Under the action oi Aconite
Belladonna, Arsenicum,^ vxVomica, Ignatia,BJid Hepar Sulphuris,
with occasional doses of Chamomilla, Coffea and Hyoscyamus, all
the painful and distressing symptoms gradually disappeared, the
fever abated, the appetite and sleep were restored, and the power,
of moving without provoking pain or bringing on a relapse
returned. She was able to walk, and take long drives into the
country, and drive over the stones in town without bringing on
pain, which she had not been able to do for months. She was
sent into the country for change of air, to assist in restoring her
strength and recovering her flesh. Just at this period, before she
had recovered the full tone of her former good health and pre-
vious healthy constitution, she unfortimately became again
pregnant. He had entered much more at length into these
details than he would have done, because he baew the early
history of the case, and because he was of opinion that the
accident mentioned by Mr. Leadam, or rather shock which her sys-
tem had received from being ran away with in her pony carriage
had nothing to do with the extra-uterine foetation. This he believed
must have occurred within the first ten or fourteen days of her
pregnancy, which state of pregnancy had been communicated to
him by letter a considerable time before the ponies ran away
with her. He thought it was more probable that the reduced
state of her health from the long and severe suffering and illness
she had experienced from the disease in the womb and in the
rectum, had contributed to the misfortune which had terminated
in death. From the very earliest period of gestation, threatening
symptoms set in. On the 14th of September, the medical prac-
titioner in the country where she was staying, reported to him
(Dr. Quin) as follows. " I first saw her on the 9th, when she com-
plained of pain and a sensation of weight about the pubis and
Mr. Leadam on Eoctra-Uterine Oestation, 209
acarum ; there was a rather brownish-coloured discharge from the
vagina^ which she mentioned had occurred at intervals during the
pievioos week or ten daya This discharge had not at all the ap-
pearance of the catamenia,but resembles that which frequently pre-
cedes an abortion. These symptoms had, on the 12tli, in a great
measore subsided, by perfect rest on the sofa and small doses of
Hyosyamus. When on the 13th, she was seized with severe
pain in the muscles of the chest and abilomen, accompanied
with occasional vomiting, great thirst, and great distention from
wind. The discharge from the vagina is nearly gone, but there
is still a sensation of great weight at the lower part of the
abdomen. You are aware that it is now more than nine weeks
since there was a discharge of a decidedly catamcnial charac-
ter." These symptoms, he learnt from subsequent reports wliich
were sent to him (Dr. Quin), frequently recurred, accompanied by
much pain and discomfort in the left side in the ovarian region,
notwithstanding she was kept as much as possible in the re-
cumbent posture. Every exertion and attempt to move pro-
voked a recurrence in a violent form of these painful and dis-
tressing attacka Towards the beginning of December, 1862,
she was brought to town to be under his (Dr. Quin's) imme-
diate care and treatment until the time for parturition ap-
proached. Subsequently the suspicious and anomalous symptoms
differing from those usual in natural and healthy gestation, made
me desirous of associating Mr. Leadam with me in the treatment
of this complicated, and at that time, obscure case, earlier than
in ordinary circumstances would have been necessary ; and it is
but justice to him to state that after making the requisite local
examinations, his diagnosis of the case from the time that the
usual period for parturition had elapsed, and even for some time
before, was justified by the subsequent events and by the post
mortem examination. As may easily be imagined, in such a
complicated state of organic disease as latterly existed, the sym-
pathetic irritation of the nervous system and disturbance of the
digestive organs became more distressing, and the pains at times
were dreadfully acute, whilst the treatment and conduct of the
case increased in difl&culty. The patience of the poor sufferer was
most touching, and greater than could be supposed possible by
any one who had not witnessed it. In all her acute sufferings and
distress she never lost confidence in Homoeopathy, and even
up to the last she resisted every attempt at persuasion to have
recourse to Allopathic treatment, which some well-meaning
friends, who ignorant of the real nature of her state, and dis-
posed to attribute her danger to the want of efficacy of
Homoeopathy, had endeavoured to induce her to do. With re-.
VOL. in. 14
210 Mr. Cutmore on sorne Morbid Affections of the Ear,
spect to the observations of Dr. Drury in relation to an opera-
tion in this case, it was the opinion of all the medical men
who had seen the patient, that such an attempt was inadmis-
Bable, and could only have increased her sufferings and ac-
celerated the fatal issue. The autopsia proved how correct
was this conduct of her medical advisers, seeing the adhesions
that had taken place and the ulceration communicating from the
sac formed in the fallopian tube or left oviary through the peri-
toneum to the sigmoid flexure. In the earlier part of these
observations, he (Dr. Quin) had stated his disbelief that the
shock of the pony carriage — ^being landed in a ditch — ^had
anything to do with the extra-uterine fcetation, and he was
disposed to agree with Dr. Drury, that mental causes and
deteriorated health were more likely to lead to such abnormal
cases of conception than physical shocks or accidents. Fortu-
nately such cases as the one brought under the consideration of
the Society this evening are very rare, this is sufl&ciently proved
by the few instances on record collected from various countries
and extending over a very long period of time.
ON" SOME MOEBID AFFECTION'S OF THE EAR.
By Charles Cutmore, Esq., M.RC.S. & L.M. Eng.
Gentlemen,
Before I speak of the general treatment, I will describe
the Anatomy and Pathology of the Internal Ear, merely with
the view of facilitating and simplifying the mode of treatment
of the morbid structures connected with the organ of hearing.
It is to be regretted that our Materia Medica is so barren
in objective symptoms, relating to diseases of the ear, of which
the great majority only can be diagnosed. The diseases of that
organ principally arise from an altered state of their natural
structures, and are only recognised by the eye, ear, and touch,
whilst the subjective symptoms express pain, pressure, fulness
and noises in the ears, arising from a disordered state of the
portia-mollis, chorda tympani, anoemia, or congestion of the
Mr, ChUmore on some Morbid Affections of the Ear. 211
vessels supplying those parts, upon which very little reliance
can be placed in regard to their efiicient treatment ; the diag-
noslB must then really rest upon those objective and more
trustworthy symptoms. The various diseases of the ear are
generally devoid of any symptoms for the surgeon's guidance of
treatment, and depend in many instances u^KDn morbific changes
which are only curable by constitutional treatment, while
others are relieved by the local application of remedies to the
Yaiious structures.
I shall first mention some alterations of the structures which
are liable to become diseased, or altered from the normal state,
and produce deafness : —
1st. The diseases of the ceruminous glands.
2nd. Acute and chronic inflammation of the dermoid meatus
which generally terminates in polypus.
3rd. Polypus.
4th. Exostosis of the external meatus.
5tL Diseases of the membrana tympani.
6th. Obstruction of the eustachian tube.
7th. Diseases of the cavity of the tympanum.
8th. Disease of the mastoid-ceUs.
9tL Nervous deafness.
The Ceruminous glands are about the size of millet seeds,
placed exteriorly to the dermoid meatus, in the interstices of a
reticulated membrane; the cerumen they secrete is useful in
keeping the canal of the meatus and the membrana tympani in
a state of moisture, necessary for health, and to transmit
sonorous sounds. On examining the ear when in a healthy
condition, you will find a ceruminous circle, consisting of fine
hairs, covered by a sort of glutinous dew; but in a diseased
state of those glands it is absent, and presents an accumulation
of hardened wax, which fiUs up the meatus, causing pressure
upon the membrana tympani, and giving rise to deafness,
vertigo, noises in the head, and very often producing s}Tnptoms,
in highly-nervous persons, similar to pressure on the brain, from
14*
212 Mr, Cutmore on some Morbid Affections of the Eixo'.
the hardened mass pressing upon the ossicles through the
membrana tympani against the contents of the vestibule.
The treatment in such cases is simple. I will relate one of
many that have come under my care.
Case.
Abraham Shilling, aged 63, fisherman at Dover. For many
years had suffered with deafness, also vertigo and violent noises
in the head and ears (nearly depriving him of his livelihood on
account of his deafness). Examined the meatus with the
speculum and discovered a hard, black-looking mass, which on
being touched caused great pain in the head ; he also expressed
that he had not been able to lie on the affected side for years
without feeling distressed ; the hearing distance of the watch was
contact. Syringed the meatus with warm soda-water, which
brought away a hardened mass of cerumen and epidermis,
leaving the meatus absorbed, red, and granulated ; touched the
meatus with a solution of Arg. nit. gr. x aquse 5, with a
camel-hair brush ; the hearing distance increased three feet (that
being the normal standard), and the whole of the unpleasant
symptoms left him.
There is another disease which affects the ceruminous glands,
viz., a deficiency of wax. This generally happens to persons
disposed to rheumatism and of a gouty diathesis, chlorotic
females, and those suffering from long continuous discharges,
viz., leucorrhoea, haemorrhoids, &c. ; also, the disease arises from
a diseased condition of the throat and tonsils^ which occurs in
a scrofulous diathesis.
The treatment here, must be entirely constitutional, and
vary with the peculiar idyosyncrasies of the patient, so as to
restore a healthy secretion of the glands.
I have foTmd Spongia an excellent remedy where there is a
total deficiency of wax. I will now pass on to another disease
of a more serious nature, viz., acute and chronic inflammation
of the dermoid meatus. This membrane is subject to inflamma-
tion from many causes, such as the accidental introduction of
Mr, Outmore an some Morbid Affections of the Ear. 213
any foreign body, an accumulation of cerumen, the ap])li-
cation of cold or heat, arising especially from a sudden
change of temperature in the weather, or any debilitating ill-
ness. The symptoms of the inflammation are similar to those
which attack any other part of the body, added to a sensation
of fullness and uneasiness in the meatus, inci-eascd by a
pressure on the external ear, causing singing, throbbing, and
acute pain, the pulse becoming accelerated with great restless-
ness and anxiety. Should the affection advance, the dermis
becomes tumefied, so as to considerably diminish the calibre of
the meatus; the pain continues to increase, and in a short
time a copious discharge suddenly takes place, followed by
immediate relief ; upon removing the secretion with a syringe,
the BurfSace of the tumefied meatus is seen to be of a deep red
colour, and the epidermis entirely denuded, secreting a muco-
purulent fluid.
The treatment in this stage should be hot fomentations, or
an evaporating lotion applied to the meatus on cotton wool, or
a poultice with a few drops of tincture on its surface, of the
same medicine as prescribed intemaUy, but of a lower dilution,
such as Aeon, Bell., Puis., or Mer. v., and to syringe the meatus
three or four times a day with warm water, medicated witli the
same remedy as taken internally, so as to be absorbed by the
denuded surfaces of the meatus. Should the above symptoms
be allowed to remain, or the patient not present himself for
treatment until the chronic stage is developed, many of tlie
important structures of the ear, are, to a certain extent, injured
by hypertrophy of the dermoid meatus, which causes a narrow-
ing of the external orifice ; should the hypertrophy extend to
the dermoid layer of the membrana tympani, the power of
hearing is much impeded, and very often lost. Sometimes in
the chronic stage, the symptoms take on the catarrhal, espe-
cially in those persons of a scrofulous diathesis, with glan-
dular enlargement, and who are exposed to a low, damp, or
moist atmosphere.
214 Mr. Cutmore on some Morbid AffeetioTis of the Ear.
The distinguishing point between chronic inflammation and
catarrhal, is the peculiar character of the discharge from the
latter being of a very muco-purulent form and of a very-
offensive kind. When the disease has remained some time, the
mucous membrane of the tympanic cavity is apt to be impli-
cated, and deafness of a more serious kind is the result ; how-
ever, it must be remembered, that catarrh of the dermoid
meatus, and of the dermoid layer of the membrana tympani,
frequently is a symptom of ii^ritation witliin the tympanic
cavity, and the external symptoms cease so soon as the inter-
nal irritation is relieved, by bringing the mucous membranes of
the throat, tonsils, and eustachiah-tube into a healthy state
with the remedies I shall hereafter mention.
In treating chronic diseases of the ear, and especially those
which arise from a debilitated constitution, the treatment should
be directed towards reinstating the general tone of health, prior
to the application of local remedies, which, according to ex-
perience, are necessary for the restoration of the diseased
structures. In chronic discharges of the ear of a purulent
kind, I find that Bell., Mer. s., Puis., and Sulph., to answer well ;
if of a syphilitic character. Nit. ac., Mer. rub., Aur. m., Hep.
Sulp. ; and if caries of the ossicles and mastoid cells, Aur. mu.,
Sili. Cal, Assaf. The meatus must be first syringed with warm
water, previously medicated with ten drops of a low dilution
of the remedy as prescribed internally, or applied to the
meatus on cotton-wool, each medicine given according to the
pathogenesis of the diseased state; in conjunction with the
above, it is of paramount importance to use every means to
invigorate the health, by abundant exercise in the open air in
the country, or by the sea-side ; sponging the body daily with
tepid salt water ; a simple, nutritious, but not a stimulating
diet, and, above all, sleeping in a cool, well-ventilated apart-
ment, aided by those Homoeopathic remedies, that will place the
digestive organs in a healthy condition^ to digest those aliments
which will nourish and invigorate the body.
Mr, Outmore on some Morbid Affections of the Ear. 215
There is another method of treatment which I prefer in
those cases wliere there is much hypertrophy of the dermoid
meatus with large granulated surfaces, which discharge a
muco-puTulent fluid, or a continual exfoliation of the epidermis,
from chronic congestion of the dermoid meatus; first, to
syringe the ear with warm water in which a little carbonate of
soda has been dissolved, and then ai)ply to the external meatus
a solution of Arg. nit. gra. ij, aqute 3ij, with a camel-hair brush
twice a day. This remedy seems to act like a charm, by re-
lieving the congestion of the capillaries of the dennoid meatus,
and membrana tympani, especially in chronic cases, which have
defied all other treatment.
I wiU now give an illustration of a case of chronic in-
flammation of the dermoid meatus, with treatment.
Henry CrapneU, aged 9, Dover, June 5tli, 1860. Deaf six
years from scarlatina, previously treated by several surgeons.
Had a very offensive discharge from the right ear of a muco-
purulent kind. Left ear healthy. Examined the meatus ex-
temus and syringed ; the dermoid layer of the meatus being
much denuded and congested with granular surfaces, the mem-
brana tympani opaque and soddened. Health good. Hearing
distance of the right ear, of the watch, contact. Syringed the
ear with warm water in which a little soda was dissolved, and gave
Sulp. Prescribed BeU. 6 gL x. Lotion the same as medicine.
June 12th. — Discharge less. Tongue coated. Hearing dis-
tance, right ear, three inches.
Eepeat the medicine.
June 18. — ^Discharge the same.
Pencilled the meatus with Arg. nit. gr. v. aquas ^ ; Mer. cor.
vi. gL X., to be taken internally.
June 25. — ^Discharge less. Hearing distance of right ear
seven inches.
Mer. cor.
June 2 &:— Discharge the same. Hearing distance of right
ear, eight and a-half inches.
216 Mr, Cutmore on some Morbid Affections of the Ear.
Mer. cor., with lotion of ditto, pencilled the meatus extemus
with Arg. nit.
July 4. — Discharge thick and more healthy. Hearing dis-
tance of right ear, eleven inches, pencilled the meatus externus,
and continued the medicine.
July 12. — ^Discharge nearly ceased. Hearing distance of
right ear, eighteen inches. Applied Arg. nit. to the surface of
the meatus extemus.
BeU. 6 gL x., with lotion.
July 20. — ^Discharge the same. Hearing distance of right
ear two feet.
Applied Arg. nit. as before. Sulph. 6 gL x.
July 29. — Discharge ceased. Hearing distance of right ear
three feet. Pencilled the meatus extemus with Arg. nit.
Hep. sulp. 6 gL X.
August 3. — -Cured. Hearing distance of right ear, three
feet, normal distance.
In the above case there was hypertrophy and congestion of
the meatus extemus, with discharge of an obstinate character,
and had I used only the internal remedies, without stimulating
the surfaces of the meatus, probably it would have taken a
much, longer time to have eradicated.
If this disease of the dermoid meatus be allowed to remain
in a chronic state any length of time, polypi is generally de-
veloped from the granular surfewes ; sometimes, however, they
arise from chronic inflammation of the tympanum, or from
obstruction of the eustachian tube, but mostly from the dis-
eased surfaces of the dermoid layer, and at other times from
the membrana tympanum ; when the growth is large, a sen-
sation of fulness is felt in the ear, and not unfrequently a sen-
sation of heaviness, vertigo, and confusion in the head. These
cerebral symptoms often cause alarm.
The pressure of the polypus on the exterior surfaces of the
membrana tympani and chain of ossicles, causes tension of the
fluid in the vestibule.
Mr. Cutmcre on some Morbid Affections of the Ear. 217
There are two kinds of polypi The fibro-plastic, or gela-
tinoiis, and the cellular^ or vascular polypus.
The fibro-plastic, or gelatinous polypus, generally grows from
the ceruminous glands, and sometimes from other parts of the
dermoid layer of the meatus, springing from a single root or
peduncle, of a pale, fleshy colour, insensible to the touch, and
grows slowly, frequently accompanied by otorrhoea, the discharge
diminishing as the growth of the polypus advances.
The treatment is simple, merely removing it, when large,
with a pair of ring forceps, seizing it as near to the root as
possible, and giving it a twisting movement ; having done thus,
means must be employed to eradicate its recurrence, which is
of frequent annoyance. The treatment I have hitherto used
has been successful, viz., pencilling the dermoid meatus daily
with a solution of Arg. nit. gr. v. aqudB ^ ^^^ its removal,
and attending to the general health, with those remedies pre-
viously mentioned in the treatment of the meatus extemus.
This fibroid-pla-stic, or gelatinous poljrpus, is generally of a
purely local character, merely springing from the excoriated and
diseased surfaces of the dermoid meatus.
Case illustrating the fibroid-plastic or gelatinous polypus,
with the treatment.
Miss E — B — aged 20. At three years of age had scarlet
fever ; since that time had a constant discharge from both ears
of a purulent kind, the health remaining very good ; the dis-
charge was not particularly noticed, the medical attendant in-
forming the parents that it was healthy, and not to stop the
dischaige on any account. At 16 years of age, a substance
was observed in the external meatus of the left ear ; their medi-
cal man termed it a polypus, and removed it without any treat-
ment In the course of a year another grew, which was removed
in the same way, and a third, which was removed also, besides
several small ones, which turned black and dropped off.
March 13th, 1861. — Came under treatment.
218 Mr. Cutmore on some Morbid Affections of the Ear,
I observed a fibro-plastic or gelatinous polypus, from the left
ear, extending outside the external meatus to about the size of
a walnut, the right and left meatus secreting at the same time
a muco-purulent pus ; the polypus was insensible to touch, and
of a fleshy kind. Syringed the surfaces of both meatus with
warm water, in which some carbonate of soda had been dis-
solved, pencilled the surfaces of the meatus with Arg. nit. gr. v.
aquse ^ with a camel-hair brush ; hearing distance of the watch of
the right ear, half-an-inch. Hearing of left ear entirely gone.
Prescribed Mer. sol. 6 gL x.
March 14th. — ^Extracted the polypus from the meatus, with
a pair of ring forceps, giving it the twisting movement ; much
venous haemorrhage followed ; examined the meatus, and found
the surfaces very granulated and tumefied, the membrana
tympani being absorbed and perforated where the polypus had
grown. The ossicles intact. Syringed the meatus with Arnica
lotion and cold water ; directed it to be syringed thrice daily.
Prescribed BelL 6 gl. x.
March 15th. — Hearing distance of left ear had increased
four inches; continued the syringing with Arnica lotion.
Prescribed Am. 6 gl. x.
March 16th. — Hearing distance of left ear had increased six
inches, and discharged a thin flakey pus. Syringed with warm
water. Pencilled the meatus with Arg. nit.
Prescribed Mer. soL 6 gl. x.
March 18th. — Hearing distance of left ear the same. Dis-
charge less.
Eepeated Arg. nit. Prescribed Mer. sol. 6 gL x.
March 20. — Hearing distance of left ear seven inches.
Syringed and pencilled with Arg. nit. Bowels constipated, with
pains in the head.
Prescribed Nux. v. 2 gL x.
March 22. — Hearing distance of left ear the same. Still
discharging. Syringed with wann water and applied a piece
Mr Cutmore on some Morbid Affections of the Ear. 219
of cotton-wool steeped in Arg. nit. gr. v. aquae ^ to the orifice of
the membrana tympani, and allowed it to remain.
Prescribed Sulp. 6 gl. x.
March 25. — Hearing distance of left ear the same, right ear
two inches. Discharge ceased in both ears. Syringed both
the meatus extemus with warm water, and pencilled with Arg.
nit. Examined the meatus with the speculum, and found the
membrana tympani hypertrophied, concave and white, and the
surfaces less vascular.
Prescribed Calc. 6 gl. x.
March 27. — Hearing distance of left ear the same, right ear
two and a-half inches. Pencilled both the meatus with Arg. nit.
Membrana tympani looking healthy.
Prescribed Calc. 6 gl. x.
April 2. — Hearing distance of right and left ear the same.
Membrana tympani looking still more healthy. At church on
Sunday, heard the preacher for the first time since ten years.
Prescribed Mer. soL 6 gl. x.
April 5. — ^The same.
Cal. 6 gL X.
April 10. — ^The same.
Prescribed Sulp. 6 gl. x.
April 1 5. — Hearing distance of left ear the same ; both the
extemus meatus and membrana tympani looking healthy.
Applied an artificial tympanum to the left ear.
Prescribed Sac. lac.
April 18. — Hearing distance of left ear much improved with
the artificial tympanum. Hearing distance of right ear five
inches. Left : The hearing restored so far as the disorganiza-
tion of the ear would permit, and no recurrence of tumours.
The Cellular or Vascular Polypus.
This afiection is of a fungoid or cancerous growth, and arises
firom a low cachectic state of the constitution, poisoned either
by scarlatina, measles, or some exhaustive disease. It consists
of vascular granulations, growing frequently with a broad base
220 Mr, Cuimore on some morbid Affections of the Ear.
from the membrana tympani, or dermoid layer of the meatus,
of a red, raspberry hue, extremely sensitive, bleeds on the
slightest touch, owing to its great vascularity, and grows
rapidly, often discharging a foetid kind of pus. The treatment
of this kind of polypus is somewhat different to the former, if
large, and causing cerebral disturbance, it must be removed
with the ring forceps, and the constitution reinstated by reme-
dies, suited, according to the peculiar dyscrasia of the patient.
The following medicines may be consulted with great ad-
vantage in this class of polypus, arising, as it generally does,
from a low state of the constitution ; — Sulp., CaL, Mer. s., Mer.
ru., Ars., Nit. acL, Phos., Sepia., SiL, Hep., Staph., Lach., Rhus-
tox., Aci. sulp.
The meatus must be syringed twice a day with warm water,
containing a few drops of the Ist or 2nd dilution of the indi-
catiQg internal remedy.
I have generally used from the 6th, 12 th, and 30th dilution
in tinctures.
When the discharge is of a foetid kind, no application is
better adapted than an injection of Chlorate of Potash, gr. xx
Aqu, 5 X., syringing once or twice a day as the case may re-
quire. If the granulations are large and flabby, syringe the
meatus with Nit. aci 3 ij- ^ ^ half-pint of water, or if pre-
ferred, a calendula lotion, 3 iij. ad ^ ij. is a very good injection.
Exostosis.
Exostosis, or osseous tumours, of the meatus externus, is a
disease which frequently occurs in the middle period of life to
those persons of a rheumatic or arthritic diathesis, or those who
may be termed free livers, taking much stimulating food.
The development of the tumour is slow, and frequently un-
attended with any symptoms calculated to attract the attention
of the patient. When from a cold, or a sudden change in the
weather, causing an accumulation of cerumen in the meatus, the
aperture becomes closed, deafness is complained of, and relief is
sought; sometimes the growth of the tumour produces a feeliiig
Mr, Cutmore on some Morbid Aj^ectians of the Ear. 221
of distencdon in the ear, and a weight in the side affected. The
semiology of the disease may be confounded with polypus, or
hypertrophy of the dermoid meatus, but on an inspection with
the speculum, it soon disappears, for the polypus is of a dark
colour, and moistened with a discharge, very often of a foetid
kind, whereas, the osseous tumour is white, hard, and dry ; how-
ever, should there be any doubt, it would be removed by the
use of the probe. Very frequently there is a collection of hypertro-
phied epidermis, and on relieving the meatus of this the hearing
is much improved. The osseous growth is affected by the
application of the Tincture of Iodine on a camel-hair brush to
the internal surface of the meatus extemus; also, I have found
great assistance in this affection of the ear, from passing a con-
tinuous current of galvanism through the tumour to cause its
absorption, and attending to the rheumatic and gouty dia-
thesis by internal remedies, such as Caust., CaL, SiL, Ant. cm.,
Clem., Aur. m., Phos., Ass., Euta., Kali, bi. Hep., Sulp., lod.,
Colo., Cocc, Ehodo., in dilutions varying according to the tem-
perament and peculiarities of the patient, from the 3rd, 6th, to
the 30th dilution.
Membrana Tympaot.
We now come to another structure in the ear, which is im-
portant to keep in a healthy condition, and to restore when it
becomes altered by disease, viz., the membrana tympani I will,
en passant describe the different layers of that membrane, in order
to facilitate the diagnosis of various alterations which take
place in that important membrane, as they give rise to many
difi&culties in the treatment of deafuess.
The membrana tympani is composed of four layers, viz. : —
epidermic, dermoid, fibroid layer, and mucous.
The fibroid layer is composed of two laminas, one of radiating,
and the other of circular fibres, which are attached to the pro-
cessus longus of the malleus, keeping tense the membrana tym-
pani with the aid of the ligament of the tensor tympani muscle,
necessary for the acute state of hearing ; the mucus layer lines
222 Mr. Cutmore on some Morbid Affections of the Ear.
the tympanic cavity and covers the whole. The various diseases
which attack the membrana tympani are acute and chronic in-
flammation, the latter running into catarrh and ulceration, hy-
pertrophy, relaxation and perforation.
The four first of the diseases above-mentioned, have been
spoken of separately with their treatment, in the dermoid layer
of the meatus extemus, the dermoid layer of the membrana
tympani being continuous with that membrane.
Hypertrophy of the membrana tympani considerably interferes
with the usefulness of the organ of hearing, by destroying its
elasticity and impeding the sonorous undulations from passing
through to the vestibule, therefore, it behoves the surgeon to
use those means and remedies that will alter and avert such
consequences, and to keep the membrana tympani in a healthy
state. The best means that I can at present deduce from my
experience, is to pencil the membrana tympani with Arg. nit.
3 gs. aquae ^ L with a camel-hair brush twice a week, with the
proviso that there is not any abrasion, previously syringing the
meatus with warm water, also, by the application of a most
useful therapeutic agent for the absorption of fluid and hyper-
trophy, viz., galvanism ; I generally place the positive pole on
the upper part of the cervical vertebrae, and the negative pole
over the mastoid process, and sometimes introduce it into the
external meatus, stimulating the membrani tympani, eustachian
tube and the contents of the labjTinth.
Eelaxation of the Membrana Tympaih.
This disease is a frequent cause of deafness in debilitated
and scrofulous constitutions, also in those persons who sufier
from chronic catarrh of the nasal passages, the mucous mem-
bane being in connexion with the fauces, is generally in a re-
laxed state also.
Upon examination, the membrana tympani will generally
be found opaque, concave, and frequently hypertrophied, the
bright spot elongated, and the manubrium of the malleus
standing out prominently.
Mr. Cutmore on some Morbid Affections of the Ear. 223
The result of these objective symptoms is deficiency of hear-
ing, with a sensation of fullness in the head, and a feeling as .
if one spoke thickly.
The diagnosis of this disease is not at all difficult ; by
directing the patient to hold his nose while inhaUng his breath*
and to forcibly expire with the closed mouth, so as to force the
air through the eustachian tube, will cause the membrana
tympani to become tense and natural, and produce an ameliora-
tion of all unpleasant symptoms. In this aflfection the remedies
are mostly of a constitutional kind ; where permanent benefit
is derived from attending to the general tone of health, as
already observed, in treating chronic diseases of the external
meatus, with those medicines which have a long range of action
on the system and mucous surfaces. Dul., Puis., Carb., Nux. v.,
LacL, Cal, Sili., Mer. s., Sulp. If much hypertrophy of the
membrana tympani, the use of the Arg. nit., as before-mentioned
will be of use, in thinning and toning the fibres, aided by
galvanism, if obstinate.
Perforation.
The next aflfection of the membrana tympani that I shall
allude to will be perforation. The usual cause of perforation
of the membrana tympani, is catarrh of the mucous mem-
brane of the tympanic cavity, and not the result of ulceration,
as is generally supposed, but from that membrane secreting
too abundantly, and the natural orifice of the eustachian tube
being nearly closed by viscid mucus, is unable to carry it
away through the fauces, and the absorption of the membrana
tympani, is the result of the pressure of the viscid mucous
inside the tympanic cavity ; it generally arises from scarlatina,
measles, or chronic catarrh of the fauces.
Perforation of the membrana tympani is not always attended
with total loss of hearing, except when there is much hyper-
trophy, or relaxation of that membrane, when the power of
hearing becomes greatly diminished. The treatment is simple.
Bedace the hypertrophy by applying Arg. nit., similar to that
224 Mr, Cuimore on some Morbid Affections of the Ear.
spoken of in hypertrophy of the external meatus. When the
membrane becomes more healthy, apply a piece of moist cotton-
wool to the orifice, by means of the speculum, and with a pair
of fine plyers, or an artificial membrana tympani made of
India-rubber, so as to confine the vibrations of the air in the
tympanic cavity, and to concentrate it on the labyrintL The
diagnosis of this affection is easy; desire the patient to hold
his nose, and blow with his mouth closed, if the membrana
tympani is not pervious, you will audibly hear an escape
of air making a hissing noise through the external meatus, or
upon examining the ear with a speculum during his blowing,
you will perceive the edges of the opening expand.
The Eustachian Tubk
This is another important structure connected with the
organ of hearing, and should there be any alteration from its
natural state, deafness ensues ; it is frequently over-looked by
surgeons when searching for the cause of deafness, thinking
that the meatus and membrana tympani, ought only to be the
objects of their attention.
The especial use of the eustachian tube when in a healthy
state, is to allow ingress of air to the tympanic cavity, and
egress of mucus from it ; when mucus is too abundantly secreted,
these natural functions are impeded, either from hypertrophy,
congestion of the mucous membrane of the tube, or closed by an
abnormal quantity of mucous, so that deafness ensues; there-
fore it is necessary that the canal should be kept pervious, and
a constant interchange of air in the cavity of the tympanum.
The frequent cause of obstruction of the ^eustachian tube
arises then from chronic congestion, and hypertrophy of its
mucous membrane at the faucial orifice, and sometimes from
an accumulation of secretion from its lining membrane of the
t3rmpanic cavity; it generally arises from chronic catarrh of
the nasal passages and fauces, with enlargement of the tonsils,
occuring in persons of a scrofulous diathesis.
Mr. Cutmore on some Morbid Affections of the Ear. 225
This kind of deafness usually happens suddenly, upon taking
cold or an exposure to the night air, and very often disappears
as suddenly, with a loud crack in the ears, and an improve-
ment of the hearing, which is of short duration.
Upon examining the membrana tympani with a speculum, it
will be seen to be very concave and opaque, frequently drawn
inwards, so as to approach the stapes ; the concavity of the
membrana tympani is often a diagnostic sign of the eustachian
tube being impervious, arising either from chronic congestion,
hypertrophy, or an accumulation of viscid mucus, but the true
method of ascertaining the state of the eustachian tube is by
the otoscope, an instrument of great value in diagnosing
diseases of the ear; this instrument is an elastic tube, about
eighteen inches in length, and each end tipped with ebony, one
end is inserted into the ear of the surgeon, and the other end
into that of the patient, who must swallow a little saliva, his
nose and mouth being closed ; if then the eustachian tube be
pervious, at the moment of swallowing he will feel a sensation
of fulness in the ears, and the surgeon will hear distinctly a
crackling sound produced by a slight movement of the mem-
brana tympani outwards ; if the crackling is not heard, however
faint, there is certain to be an obstruction of the eustachian
tube, especially if the membrana tympani is concave.
In treating of these diseases of the eustachian tube and
fences, I may state that they principally arise from a cachectic
state of the constitution, brought into activity by scarlatina^
measles, residing in a damp locality, or exposure to a cold; moist,
atmosphere; such causes must be removed, and the' patient
placed in as favourable a position as possible for recovery;
also hygienic means must be resorted to as mentioned in the
treatment for chronic inflanmiation of the meatus, with the
following addition: a cold compress placed around the throat and
neck on going to bed, and in the morning to bathe the throat and
neck with cold salt water, and rub it afterwards with a coarse
towel until a glow is produced, adding the administration of some
VOL. in. 15
226 Mr, Cuimore on some Morbid Affections of the Ear,
of the following medicines — I have generally found them
Homoeopathic to the subjective symptoms of the diseases which
attack the eustachian tube and throat, each medicine prescribed
according to its correspondence with the diseased state of the
patient — ^Ammon. caust., Calc, lodi., Merc, ioda., Mer. s.. Nit.
acid, Kal. car., Kali, hydriodi. Con., Kreas., Lach., Phos., Grap.
Caust., Nat. mur.. Puis., Sili., Dulc,
DISCUSSION.
Db. Djrury, while thanking the author for his paper, felt that
the thanks of the Society were also due to Mr. Cameron, for the
excellent manner in which he had read it : good reading always
helping to place an author on better terms with his audience.
It was to be regretted that Homoepathic literature was deficient
in diseases of the ear, and he. Dr. Drury, was glad to find
that Mr. Cutmore was giving his attention to this matter, as it
was always desirable that specialities should be in the hands of
respectable practitioners. Though some able and upright men
amoDgst the Allopaths had selected this department for their
particular attention, there was no doubt that aural surgery had
not been as well represented as it might in the profession, so that
is required all the weight of a Toynbee or a Harvey to raise it
again in public estimation. When such stories were current as
that of " the watch trick," it was most desirable to see men of
standing trustiug to their own skill and integrity to raise them
above any such suspicion. What he spoke of as the watch trick,
was simply the using a loud ticking stop watch, by which the
first day, as close to the ear as possible nothing could be heard,
while on the second visit, the loud tick showed the patient how
much he had improved. Knavery of this sort had possibly
frightened some men from being associated in the same depart-
ment with such charlatans. Mr. Cutmore's paper was very in-
teresting and gave some valuable information. It was much to be
regrettecf that Mr. Cutmore had not given the indications for the
medicines, or that he had not trusted more to them and less
to what might be termed Allopathic auxiliaries. If in remo-
delling his paper he would rectify this error and give his reasons
for using certain drugs, and the effects that he could fairly trace
to them, it would much enhance its value.
Mr. Yeldham said Mr. Cutmore had adhered rather loosely
to the title of his paper, inasmuch as the most important and in-
teresting of all the affections of the ear, viz., deafness arising
Mr, Cutmore on some Morbid Affections of the Ear. 227
from disease of the auditory nerve, were scarcely alluded to. He
certainly did expect that in a paper of so comprehensive a title,*
these cases would not have been omitted. Mr. Cutmore's paper
was interesting as far as it went, in the description of ordinaiy
affections of the external ear and passages. Mr. Outmore's
treatment of these he thought was somewhat meagre, and by no
means noveL The accumulation of hardened wax in the ear
was a fertile source of temporary deafness. He, Mr. Yeldham,
was constantly meeting with cases in which relief was afforded
in a few minutes by carefully syringing the ear. This operation
must be done thoroughly to be effectual, and even then in some
cases it failed to remove the obstruction. Some time ago, a
gentleman came to him for deafness which had existed in one
ear for years, and which had been ineffectually treated. On
examining the ear, he, Mr. Yeldham, was satisfied that it
arose from mechanical obstruction. The syringe failed to
remove it. He then introduced a fine hooked instrument, like
a crochet needle, and extracted a hard substance like a bullet.
The cure was, of course, instantaneous. The patient then
recollected that two years before he had introduced a piece
of paper into his ear, which he had never removed, and this
formed the nucleus around which the wax had hardened. Mr.
Cutmore's description of inflammation of the meatus audetorus
extemus did not appear to be very distinct. He, Mr. Yeldham,
had not often met with it excepting in young scrofulous subjects,
being either idiopathic, or the result of scarlatina, and the best
remedies were those which best combated the scrofulous diathesis
— Calcar, Hepar, Sulph., Pulsatilla, Phosphorus, and cod liver
oil — a weak Arnica-lotion he had found to be the best local ap-
plication. Mr. Cutmore had omitted to mention a very fertile
source of obstructed hearing, viz., eczema of the external ear and
passage. This disease, which often attacked those parts, thickened
the Iming membranes, and caused, sometimes permanently, an
almost complete occlusion of the external canaL Mr. Cutmore
had spoken of osseous tumour and of polypus as frequent
diseases. In his, Mr. Yeldham's, experience, they were by no
means common. He had seen only one case of polypus for some
years past, and hardly recollected a case of deafness from osseous
tumour. The passing into the eustachean tube of the catheter,
which required some dexterity, was, in some cases, doubtless,
a useful operation, as it is performed by aurists. His old
friend, the late Mr. Pelcher, had passed it for him, Mr. Yeldham,
many years ago, for deafness, and afforded relief for a few hours
by expelling a globule of air ; but the relief was very transitory.
* The original title was more ambitious than the present one.
15*
228 A Case of Hcematuria and
The deafness returned and remained for months, imtil one day,
whilst he was ascending a high hill, it went off with a loud bang,
and never returned. He, Mr. Yeldham, did not agree with one
of the speakers who had preceded him in recommending Mr.
Cutmore to make diseases of the ear a " speciality." He believed
these diseases were well understood by most medical men, besides
which the Homeopathic body was at present too small to admit,
without disadvantage, of being cut up into specialities.
Mr. Cameron. — ^I cannot agree with the objections which have
been so generally made this evening against the preponderating
importance which Mr. Cutmore has given to the surgical over
the Homoeopathic treatment of diseases of the ear, for I believe
that in this class of ailments, purely medical treatment, whether
Allopathic or Homoeopathic, is seldom of much direct use. When
the aurist has directed his attention to the improvement of the
general health of his patient, or, in cases of acute pain, admi-
nistered his sedative ; or attacked, upon general principles, rheu-
matic or gouty inflammation among the small bones of the internal
ear, or their articulations, he has pretty well exhausted hisresources
of a purely medical kind. The surgical treatment of the ear, if often
not more successful, is at least not so limited in its applications, and
I think Mr. Cutmore had no choice left him in his endeavour to
present us with a comprehensive view of the diseases of the ear
and their treatment, but draw our chief attention to their surgery.
I am afraid, however, that even this is not a very successful field
of practice, and that patients, from sad experience, have made
up their minds to be satisfied with a " safe ** aurist, without ex-
pecting any great things from him in the way of cure in very
many cases. I had ample opportunities two years ago, of wit-
nessing the practice of Dr. Kramer, of Berlin, perhaps the most
eminent aurist in Europe, and was then painfully impressed with
the slender modicum of success which attended his skilful
attempts to relieve the patients whom I had persuaded to
consult him.
A CASE OF HiEMATUEIA AND ALBUMINURIA AFTER
SCARLATINA MILLARIA.
By Dr. Thinks, Corresponding Member of the Society.
[From the Neue Zeitschrifb der Homoeopathischen Kilimk.]
Antoine de S os, aged 15, of a feeble and strongly de-
veloped scrofulous constitution, of high mental endowments
AUmminuria after Scarlatina Miliaria, 229
and a nervous temperament, had suffered from many serious
attacks of disease at different periods of his life. In his tenth
year he had inflammation of the whole of the right lung, which,
never being entirely cured, left it in a state of camification as high
as the fourth rib, and it was only above this point that the respira-
tory murmur was audible. Two years later he suffered from abdo-
minal typhus, which, according to the statement of his mother,
who was minutely informed of the facts by the physicians of
Warschau who were in attendance, induced an attack of albu-
minuria. In the preceding autumn he had caught cold and was
laid up by a laryngeal and bronchial catarrh, which was cured
by a course of the Kieselbrunnen of Ems.
He passed the comparatively mild winter of 1862-68 in
perfect bodily comfort, till the 25th of February, when he was
suddenly seized with headache, vomiting, and slight sore throat.
Having then been called in, I prepared his parents for the appear-
ance of scarlet fever, as I had seen the same premonitory symptoms
in many children; and so it proved to be, for the eruption showed
itself the following night. The scarlet fever ran a very mild
course, there was very moderate fever from first to last ; the
sore throat was but slight likewise during the first three days ;
there occurred, however, a most unpleasant nervous restlessness,
which lasted day and night, making sleep impossible, and causing
lively images and slight delirium for the two first days. The
rash was not much developed, it spread as a miliary eruption
from the upper to the lower portions of the body, excited un-
pleasant itching, paled as early as the fourth day, and at the
same time the sore throat disappeared, and the fever from this
time rapidly diminished.
Under the administration of Aconite in the 2nd decimal dilu-
tion, at the rate of three drops every three hours in water, and
a couple of doses of three drops of coffea, 1st dilution, to allay
the nervous restlessness, the scarlet fever ran its course without
any further remarkable symptom. The exfoliation of the cuticle
began upon the face and neck on the seventh day, and somewhat
230 A Case of Hcematuria and
later on the other parts of the body. On the tenth day, on
account of the increased appetite of the patient, he was
allowed meat and broth, and all his functions were performed
with perfect regularity. He was kept in bed and felt perfectly
well until the sixteenth day, on the early morning of which his
mother observed swelling of the face and of both hands, and
showed me on my visit that there was albumen in the urine,
for before 1 got to the house, indeed whenever she noticed
the swelling, she had boiled some of the water, and the amount
of the albumen was very considerable. The urine reddened
litmus paper. Taught by former experience, I was in no hurry
in prescribing a medicine, for I had frequently observed that
blood appeared after the administration of HeUeborous niger. I
had formerly ascribed this appearance to the t/OO powerful action
of this remedy, and I wished to observe whether the same
symptom would appear without the use of any medicine what-
ever. The result justified my suspicions, for next day I found
blood in the urine, and this rapidly increased in quantity during
the following days without the use of any medicine ; so that
the whole urine, which was not inconsiderable in quantity, was
of quite a blood-red appearance. There was no increase of
thirst. The secretion of urine in respect to its amount seemed
at the same time much increased ; it also showed the same con-
siderable quantity of albumen when being boiled. The swel-
ling of the face and hands did not increase, and this anasarca
did not extend itself to other parts of the body, as rapidly hap-
pens in cases of this description.
Looking upon this hsematuria as an active hypersemia of the
kidneys I did not wish to take energetic measures to subdue it.
However, the marked retardation and compressability of the
pulse, the increased feebleness of the action of the heart, the
anaemic murmur in the ventricles, the paleness of the face and
lips of the gums and tongue, informed me that a state of
anaemia was being established, notwithstanding that the appetite
continued good and that the digestive functions including defe-
Albuminuria after Scarlatina Miliaria. 231
cation went on with regularity. Sleep, too, remained undisturbed,
althougli the patient was not strengthened by it.
On the 6th day of the attack the urine contained a very
large quantity of blood, which fell to the bottom of the vessel,
and also a large quantity of albumen ; it had lost all the proper
urinous smell, and was passed in considerable quantity, the
oedema of the face and hands was gone, but the other symptoms
continued to run their own course. Having in view chiefly
the necessity of arresting the progress of the anaemia and
nephritic haemorrhage, I ordered the patient 3 drops of the 1st
decimal dilution of China every four hours, and to take a
nourishing but at the same time easily digested diet, consisting
of slightly roasted white meat and broth.
In two days after the administration of the China, the
quantity of albumen in the urine decreased, and this diminution
continued to advance each day, while on the other hand the
quantity of blood in the urine was only slightly affected, and
it was not till after the albumen had entirely disappeared, and
the quantity of the urine had sensibly lessened, that the blood
very gradually and slowly disappeared. After the entire dis-
appearance of the blood, the urine passed during the night de-
posited a large quantity of reddish crystals, which were
recognised as those of cystecin when viewed under the micro-
scope. After a few days, they, too, entirely disappeared, and
the patient rapidly advanced to a perfect sense of health both
of body and mind.
China in this case first cured the albuminuria within a few
days, then the nephritic haemorrhage, and then the anaemia this
occasioned. The further development of the general dropsy was
visibly checked likewise by this remedy, so that the organism
was spared the effect of absorbing the serous effusion in the
subcutaneous cellular tissue. Should other practitioners find
China of use in similar cases, the sphere of action of this
remedy, otherwise so valuable, will have received an important
eztention.
232 A Case of HcematvHa and
In severe cases of scarlet fever, I have always found that the
kidneys, as well as the brain, were affected from the beginning,
although sometimes in a slight, at other times in a severe
degree. Either diabetes insipidus without any albumen oc-
curred, or the opposite condition was present, and along with a
diminished secretion, the urine, on being boiled, exhibited traces
of albumen. This particular direction of the scarlet fever poison
towards the kidneys explains the frequent appearance of albu-
minuria and hsematuria as consequences of an attack of scarlet
fever, both of these affections being uncommon in other exan-
themata. Neither errors of diet nor exposure to cold give rise
nor are the cause of this albuminuria, but the chief cause is this
sole and only one, that the scarlet fever poison has not been
fully eliminated from the system, and this it is that produces
this peculiar affection of the kidneys in such cases. It is
chiefly in persons of a highly-scrofulous constitution in whom
this sequela occurs during the process of desquamation.
In the case just related I was induced to prescribe China on
account of the rapid development of the anaemia, also from the
character of the haemorrhage, for I had not before observed that
this medicine exerted so decided an action in checking albu-
minous urine. The result was the more surprising to me, as I
had not found the least diminution in the quantity of albumen
produced by the administration for a long time of the Sulphate
of quinine in the instance of a patient of sixty years of age,
whose case was one of idiopathic albuminuria. In cases of
simple albuminuria after scarlet fever, with serous infiltration
of the subcutaneous cellular tissue of the face, the limbs and
the whole body, but without consentaneous hsematuria, Helle-
borus niger has always proved suflBicient, and I never have had
occasion to employ Arsenicum ; the Hellebore alone has always
sufficed to cure the affection.
As the therapeutics of scarlet fever gradually becomes more
and more perfect, both in reference to the treatment of the
disease itself and of its complications and consequences, we may
A Case of Paratyphlitis, 233
indulge the hope that in the course of time we shall discover
the appropriate remedies for the cerebral aflfections, for the most
part &Ltal, by the general or partial paralysis of the brain —
affections generally incident to children under five years of age,
and manifestiQg themselves with the development of the attack
of scarlet fever, and which also, although much more rarely, are met
-with in adults ; and that we shall likewise discover the proper
remedies for the diptheritic affection of the mucous membrane
of the nose, palate, and fauces, such as commonly attacks very
scrofulous children under ten years of age, and often goes on to
a rapidly fetal termination in a condition of stupor.
Agaiost the cerebral poisoning by scarlet fever, the medicines
hitherto known and employed which act upon the brain, are
quite insufficient, and, we see without power to avert the ap-
proaching paralysis of that organ. Indeed there is hardly time
for the efforts of the physician to be effectual, for within four
or five days the sad termination takes place. It is probable
that in the diptheritic condition of the mucous membranes,
Bromine would prove of more service than Mercury or Arsenic,
which have hitherto been tried in vain.
A Case of Paratyphlitis.
Miss A. Zeidler, 16 years of age, of a scrofulous constitution,
with the exception of measles and scarlet fever, and sHght
catarrhs from catching cold, had always enjoyed good health ;
the catamenia also had appeared without any difficulties at the
age of 14, and had always recurred at the right time and with-
out irregularity of any kind.
On the 29 th of May of this year (1863), I was sent for by
the mother of this girl to see her. She had suffered for several
days from severe pains in the right side of the abdomen, with
obstinate constipation. I found the patient in bed, and on a
close examination, I discovered a broad hard tumour in the
right iliac fossa, extending down to the region of the uterus,
and above over the junction of the colon and ileum. The
234 A Case of Hcematuria and
tumour was very painful on external pressure ; in breadth it
was equal to the palm of the hand ; faecal masses could be
distinguished below the surface, and between this and them
a harder substance could be felt. Pressing upon this impac-
tion, gave the patient stabbing and pressing pains. The ab-
dominal parietes were considerably elevated by this tumour, as
was seen by comparing them with the corresponding region on
the left side. Three days previously the bowels had been freely
evacuated by a soap enema, since then there had been no pas-
sage of either faeces or flatus ; the intestinal canal consequently
contained much flatus. The whole of the rest of the abdomen
was entirely free from pain. The tongue was slightly coated
with white ; there was neither thirst nor appetite, nor was there
any eructation of wind, nausea, or vomiting. The taste was
somewhat insipid (fade) wersh (scottice) ; the pulse 70, not
hard, the head was free ; the sleep disturbed in consequence of
the pain ; the urine clear and pure, and of acid reaction.
I now got the following report as to the origin of this attack.
The catamenia had appeared six days previously at the right
time, and unattended with any pain, and had continued quite
regularly for two days ; on the third the patient had chilled her
feet, and the catamenia began to be interrupted, and in the
course of the same forenoon entirely ceased. In the afternoon
of that day the patient had experienced lively pain deep down
on the right side ; and as this had not subsided on the fourth,
and there had been no stool, her mother had given her an
cjioma of soap and water, which had the effect of emptying the
bowels of hard faeces, but without producing any mitigation of
her siifferings. To the time of my visit the only remedies em-
ployed had been some cups of St. Germain tea, with the view
of moving the bowels and relieving the pain; but no such
effect had followed; the steady increase in the pain had at last
induced her mother to seek my aid.
In consequence of the arrest of the catamenia by the patient
having got a chill in her feet, an inflammatoxy action had been
A Case of Paratyphlitis. 235
excited, which, extending firom the cellular tissne to the broad
legament of the uterus and ovarium, had advanced bo as to
involve part of the colon and ileum and the processus vermi-
formis ; and thus a case of paratyphlitis had resulted For the
tumour was not occasioned by the impacted faeces alone, as the
infiltration of the tissues and there tumification were palpable
beneath and beside this fiecal mass, and the retention of the
fiseces was to be regarded only as a necessary consequence of
this inflammatory process. Such was the diagnosis, and it was
confirmed by the further progress of the case.
Such being the condition of affairs, it behoved that energetic
measures should be at once adopted to arrest the progress of
this inflammatory condition already far advanced, to avert a
disastrous issue in sphacelus, and perforation or suppuration
and adhesion of the different portions of intestines to one
another, or to the neighbouring tissues. Accordingly, the
patient was ordered 3 drops of the 2nd decimal dilution of
Belladonna every three hours in a little water, and warm oat-
meal porridge — ^poultices were applied to the abdomen; for drink,
water which had been boiled and allowed to cool, as the fresh
spring water produced eructation.
On the 30th of May I found the condition of the patient
altogether unchanged; the pain and the configuration of the
tumefaction were exactly what they had been, the pulse was
unaltered, and so was the urine. The patient had had Uttle
sleep in consequence of the continuous pain.
May 31. — No change in the condition of the patient, which
was exactly what it had been on the previous day. No dimi-
nution of the pain or swelling, no discharge of feeces or of
flatus. Sleep very restless, pulse somewhat more excited — 85
beats in the minute. Tongue somewhat more thickly coated ;
dryness of the mouth and more longing for drink.
June 1. — The pain in the undiminished swelling increased
during the night, and as in ordinary cases of enteritis became
more severe at intervals, and of the character of colic; no flatus
236 A Case of Paratyphlitis.
or faeces passed; the urine is become thick, and the pulse risen
to above 100. The patient was altogether unable to sleep.
The thirst had increased, the tongue had become more thickly
coated. An enema of water and oil was administered without
any result. Notwithstanding all this, no change was made in
the medicine.
June 2. — The patient had had no sleep all night in conse-
quence of the recurrence at very short intervals of the colicky
pain in the right inguinal region, and this had produced the
greatest restlessness. The swelling, imdiminished in size, had
become excessively tender, so that the poultices required to be
made very thin. The thirst as well as the eructation were
much increased ; the severe paroxysms of pain were attended
with nausea; no faeces or flatus passed; the urine was very
thick and deposited a brick-dust sediment, its surface was
covered with an non-iridescent film, and it was very pungent ;
stni it had an acid reaction. Pulse 110 ; temperature much
increased.
By the increase of aU the morbid symptoms the insufllciency
of the medication was manifest, and the question remained
whether the insufficiency was to be ascribed to the medicine
being given in too small and in too infrequent doses, or to its
not having been rightly selected. My experience justified the
choice of the medicine, which had never played me false in the
worst cases of the most advanced enteritis; and I was compelled
to ascribe its failure in this case to its not being given with
sufl&cient frequency, and to the doses not being sufficiently
large. There was no time to lose, and not to do so by pre-
scribing another medicine which was not so suitable for the
case, I resolved to increase the dose of this one and to give
it more frequently. The patient had from this time five drops
of the 2nd decimal dilution of Belladonna in water every two
hours. The poultices were continued.
June 3. — Before midnight even, a diminution of the con-
tinued and colicky pains in the swelling and its vicinity took
A Case of Paratyphlitis. 237
place. Towards morning, for the first time for long, there was
passage of flatus. The excessive tenderness of the hard
swelling had much lessened. In the afternoon, without the
use of any artificial aid, some yellow and not very hard faeces
were passed. The eructation and nausea were absent. The
thirst was still great ; the pulse fallen to 95 ; the temperature
of the skin was reduced. The urine as before; no change
was made in the treatment.
June 4. — ^The patient had slept with some interruption, not-
withstanding the recurrence at longer intervals of the colicky
pain ; in the state of the swelling, which was as hard as ever,
there was no change, although in the early morning faeces of
the natural form had been passed in abundance ; they were not
hard, and no. artificial assistance was given; much flatus,
attended with great relief, was also passed. The tongue was
cleaner, there was no more eructation, the thirst was lessened,
the pulse was 90; the urine thidk, without the film, and
with the red sediment. The skin was of natural temperature.
The medicine was now given every three hours.
June 5. — ^The colicky pains have entirely subsided, but the
swelling, which still retains its old form, is still very tender to
the toucL After midnight a copious discharge of faeces of a
natural form, preceded by an emission of flatus, occurred spon-
taneously. The tongue is now almost clean, the thirst very
moderate, the pulse 85, the temperature natural, the urine re-
mained clear, and had an acid reaction. The medicine was
now given every four hours.
June 6. — ^The patient had slept the whole night calmly, felt
better in consequence, and desired some food. The tumour,
which has greatly diminished both in height and breadth^ was
still very painfully sensitive. It was easy to perceive that the
focal accumulation had been removed, but deep down a hard
oval body could be distinguished ; there was no fluid effusion
round this, for the percussion tone was quite clear but quite
" empty" over this body. Pulse 80 ; urine clear. On this
238 A Case of Paratyphlitis.
morning also there was a slight alvine evacuation. The medi-
cine was given only every six hours.
June 7. — ^The swelling could still be distinguished lying
deep backwards, as an oval, hard, painful, body. The appetite
was strong, and was allowed to be satisfied ; the stool was of
natural figure, and very copious. Pulse, urine, sleep, were all
natural ; the strength returned ; the medicine was given only
night and morning.
After six days I could discover only the faintest trace of the
tumour. All the other functions were normally discharged,
there was a daily and sufficient stool, and the patient felt
herself again quite strong. The medicine was however per-
severed in night and morning.
After other five days every trace of the tumour had entirely
disappeared, and so all farther medication was given up. In
due time the catamenia made their appearance and ran their
nominal course.
I may now be allowed to add some observations to the nar-
rative of the cure of this severe disease. The reputation and
success of Hahnemann and Homoeopathy were begun and
grounded by the splendid early cures made of very severe
diseases, acute as well as chronic. All these brilliant cures
were made with large, often very large, powerful medicines,
given in often-repeated doses. The physiological provings, too,
which are contained in the first volume of the " Materia Medica
Pura," were for the most part begun and carried through
with very large doses, as I learned from the communications
of Hornburg, Franz and others. I was acquainted with a
Dr. Anton, a relative of the psychologist Heinroth, who had
also proved medicines for Hahnemann, but who had got them
in such strong doses that they made him seriously ill, and
frightened him from Homoeopathy altogether.
Probably Hahnemann himself was induced by a similar ex-
perience in the proving of medicines, as well as by the occasional
pathogenetic effects produced upon patients by the administra-
A Case of Paraiyphlitis, 239
tion of strong doses of medicines, to dilute the medicines, in order
to prevent this medicinal action in patients. From this period
Homoeopathy entered into a new phase. Hahnemann appeared to
have been thoroughly penetrated by the dread of too powerful
effects from the medicines in disease, and this fear pushed him to
the opposite extreme. This dread beclouded his otherwise sober
and keen powers of observation ; every aggravation of disease
that occurred after the administration of a medicine he attributed
without further proof to the effects of the medicine taken, and
it was this dread which led him to promulgate the dogma that
the most minute dose was sufficient to cure the severest disease,
and ultimately induced him to announce the theory of poten-
tizatipn, a theory destitute of all foundation upon facts. It was
necessity alone which compelled Hahnemann from time to time to
lid himself of this fear of the too powerful effects of drugs ; as
for example, when he found it necessary to administer Camphor,
both externally and internally, in strong doses, in cases of the
prevailing epidemic of Asiatic cholera.
Hahnemann's sphere of practice had in the course of time
become so peculiarly constituted, that he was withdrawn from
the direct inspection and observation of all acute diseases. In
Leipsig, as well as at Koethen, he saw only patients who were
able to go to him, and these were for the most part the sufferers
from chronic diseases. It was probably this fact which gave
him so strong a preference for this class of patients, — a pre-
ference which carried him so far that he gave both myself and
my deceased colleague, Dr. Wolf, the advice to decline under-
taking the treatment of acute cases ! In this way, all acute
cases had to a certain extent become strange to him, and had
been kept entirely out of his sight, and this necessarily induced
in him a certain one-sidedness. In chronic diseases he had
gone so far as to have noted down each particular symptom
which made its appearance in a patient, it might be weeks
after the administration of a medicine, and these notes com-
posed the greater part of the materials out of which the
240 A Case of Paratyphlitis,
provings of the so-called antipsoric medicines were derived.
Hence the efforts of my respected friends Dr. Eoth and Dr.
Langheinz, of Darmstadt, are not only worthy of the highest
praise and fullest recognition, but the work in which they are
engaged is of the most urgent kind, — for the purification of
the Materia Medica is a work of absolute necessity.
It is now, however, full time that the dogma just referred
to should be struck out of the Organon, and that the potenti-
zation theory should be given up as a part of the doctrine
of medicinal action, — ^being, as it is, in direct antagonism to
all experience. I have said even to Hahnemann's face, and
demonstrated to himself the fact, that it is not possible to
potentize into more powerful efficacy upon the animal economy,
wine and alcohol, by the addition of water, and that both these
substances must, according to his own definition of what
medicines are, be reckoned sucL He never replied to this
representation.
The foregoing narrative of the cure of so serious a disease,
affords us a fact of important consequence. It demonstrates
that the operation of a well-chosen medicine in small doses,
repeated at considerable intervals, is often insuf&cient to cure,
but that by increasing the strength of the dose and repeating it
more frequently, the intensity of the disease may be broken and
overpowered, and its cure achieved.
Note. Langheinz, whose name is but little known in this
country, published an article in the recent number of the
" Vierteljahrshrift " upon Opium. He states that out of 518
symptoms to which the references gave him access no less than
210 ought to be struck out. He shows the symptoms of Matthaei,
Machart, Hunter, Eademacher were observed principally in
persons suffering from iUness, also those by Young, and the pre-
parations he employed were not pure, that Schillhammer's opium
was combined with crocus, iEplis with rhubarb ; also Miiller
and Stutz employed mixtures, while those of Friend, Bergius,
Murray, Geofifroy, EttmiiUer, WiUis, and Haller were merely such
hypothetical symptoms as are found in the manuals. Buoff's
symptoms are utterly worthless.
A Case of Paratyphlitis, 241
I could bring forward likewise other cures of acute and
chronic diseases to confirm these facts, and I will do so if God
should grant me a longer life. I wished, however, by the com-
munication of the one experience, to make my Mends observant
of this — that we must resolve to leave the path which Hahne-
mann has hitherto marked out, that we must make up our
minds to accommodate the dose of the medicine to the degree
of intensity of the disease we treat, that we must abandon as
an error that a small or the smallest dose is sufBicient for the
cure of every — even the severest of diseases. This is demanded,
as well on account of suffering humanity, as because it is a
fancy equally destructive to science, and one which undermines
the strength and power of the Homoeopathic system of medi-
cine, and deprives it of its full value and recognition.
DISCUSSION.
Me. Teldham said, — ^Albuminuria, it was now well ascertained,
since it had become the custom to analyze the urine, was by no
means a rare occurrence, and probably it was much more common
than was even now imagined. The most frequent cause of it
was beyond a doubt, a previous attack of scarlet fever. It was
generally said to bear a close relation to the severity of the skin
diseasa It might be so ; but the rule had large exceptions — of
this he was perfectly satisfied from his own experience. Nor
did he think that exposure to cold, and errors in diet after scar-
latina, had much to do with inducing albuminuria. He had
treated many cases in which every precaution in these respects
was taken, and yet dropsy had occurred. He believed the great
predisposing cause to be a peculiar delicate scrofulous constitu-
tion. Not long ago he had a whole family of children under
care with mild scarlet fever who, under his own strict injunctions,
were taken the greatest care of, to prevent chill or improper
feeding, because he anticipated, from the temperament of the
children, that dropsy would follow, and his prediction proved
but too true. They were all pale-faced, delicate children, and
all had anasarca. He would not dwell on the treatment of albu-
minuria after scarlatina ; on that they were pretty well agreed.
In Aconite, Arsenic, Hellebore, Cantharis, and Terebinth, they
possessed very powerful and generally successful remedies.
When albuminuria occurred as the result of Bright's disease,
it was very questionable whether any treatment would succeed.
VOL, ni. 16
242 A Case of Albumimcria and
He thought Dr. Trinks' selection of China very interesting. He,
Mr. Yeldham, regarded that medicine, in low dilutions, as a most
important medicine in many cases of atonic inflammation. He
believed that it excited the contractility of the capillary vessels,
pathogenically on the healthy body, curatively in disease — Whence
its relation to ague — hence its power in averting haemorrhage —
hence its curative action in inflammation, which consisted in
dilatation of the capillaries. He thought they were much indebted
to Dr. Trinks for the examples he had given of the good effects of
low dilutions, as they were also indebted to those gentlemen, who,
on the other hand, exemplified the effects of the high dilutions.
All this went to confirm the opinion which he believed was en-
tertained and acted upon by the soundest practitioners of
Homceopathy, viz., that all the dilutions of medicines were curative
in certain cases, and that he was wisest who restricted himself
to no particular dilution, but availed himself, as circumstances
might require, of all of them.
Dr. Wyld (of London), did not think that much was to be
learned from the case of albuminuria following scarlatina which
had been just read. This was a very common affection, and very
easily cured inthegreatmajority of cases. Dr. Wyld had had two
cases of chronic albuminuria under his care, accompanied by
general anasarca. These cases had lasted for years, but no treat-
ment seemed much to reduce the amount of albumen in the
urine, although the swelling and anasarca had nearly disappeared
in the one case under grain doses of the black-oxide of iron, and
in the other case during a month's residence in the country. In
this second case the dropsical swellings had returned, and on one
occasion the patient became comatose for two days, but recovered
under Opium 3 and Arsen. 3. Apis appeared to do most good
in one of the cases. Both cases resulted probably from degeneration
of the kidneys, although neither casts nor blood discs have been
observed in the urine. Dr. Wyld would be glad to know if any
gentleman present had ever succeeded in curing chronic albumin-
uria, the result apparently of kidney disease. Arsenicum was
probably our best remedy, but in both the cases referred to it
had failed to do much good. With regard to the case called
paratypJditis, it did not appear very clearly made out There
appeared to have been the presence of a tumour without any in-
flammatory action to begin with, and secondly the tumour was
felt as " an oval moveable tumour.'' Was it a phantom tumour,
or was it a moveable kidney? The cure being effected by Bella-
donna might to some extent point to an hysterical origin. Dr.
Wyld had seen an hysterical tumour which perfectly simulated
a hard fibrous tumour, but which always melted away when the
patient was placed under chloroform, and re-formed as the
influence of that drug subsided.
A Case of Paratyphlitis. 243
Dr. Hughes said — I heartily join in the admiration generally
expressed for this and all other practical papers by Dr. Trinks.
I agree with him, that the renal affection is not an accident in-
cident to the convalescence from scarlet fever, but is of the essence
of the malady. But I think we should draw an incorrect in-
ference from his narrative, if we concluded that the China exercised
any direct curative influence upon the congested kidneys. There
is no evidence that China is a specific irritant of the renal paren-
chyma, like Terebinthis, Cantharis, Arsenicum, and Mercurius
Corrosivus ; and it can never take the place of either of these
remedies in the treatment of nephritis. Its value in the case
before us seems to me purely dependent on its well-known power
of antidoting the bad effects of loss of blood, from which Dr.
Trinks' patient was plainly suffering when he saw her. I have
no doubt that he acted wisely in treating this serious general
effect of the local mischief, and leaving the latter to right itself ;
but it is important that we should understand this to be the true
rationale of his successful treatment. I have not met with the
paralysis of the brain in scarlatina, of which Dr. Trinks speaks
so despairingly ; but the experience of Dr. Elb of Dresden, and
others, would seem to prove that we have in Zinc a very potent
remedy for such a condition. The diphtheritic complication I
have found almost universal in severe cases; and, except in
malignant forms of the disease, have much confidence in the
Biniodide of Mercury for its removal With regard to the
■ second case, I cannot agree with Dr. Wyld, in the doubt he has
raised as to the diagnosis. I think the inflammatory nature of
the disease very plain ; but regret that Dr. Trinks seems to have
left out of sight in his treatment the evident implication of the
peritoneum in this process. I cannot but think that, had he
recognized this, he would have found much help from Mercimus
Corrosivus in the management of the caso.. I look upon this
medicine as almost infallible when in inflammation of any of the
abdominal organs, the peritoneal covering becomes implicated in
the morbid process. I well remember a case of ovaritis in which the
y]i Corrosidfe Sublimate — ^the first medicine administered-^-removed
/ in a few hours the sharp, cutting pain of serous inflammation,
and left behind the dull, sickening misery characteristic of
ovarian congestion, — which in its turn yielded beautifully to the
steady use of Pulsatilla. I am compelled, moreover, to question
the Homoeopathicity of Belladonna to a malady of this nature,
and to doubt very strongly whether it contributed much towards
the recovery of this patient. Dr. Trinks tells us that he per-
severed with the drug, because in the worst cases of enteritis in
the highest stage, it had never refused him its aid. But surely,
upon fir, Trinks' own showing, this was no case of enteritis,—
10^
244 A Case of AlhuminuHa and
by which I suppose he means, as we do in England, inflammation
of the intestinal mucous membrane. And the history of the case
seems to show the disease progressing, imchecked, to its acme,
and then as steadily declining. I cannot think that the mere
increase of two drops in dose, and diminution of one hour
in the intervals between the doses, had anything to do with the
turn of the malady.
Dr. Drury regretted very much to find that instead of that
harmony and brotherhood that ought to exist in the Homoeopathic
body, tliore was every day becoming more prominent a spirit of
opposition and disbelief — what one gentleman asserted, was
contradicted by some one else, and much good was lost by a
wholesale condemnation of those who differed, without any at-
tempt being made to extract what reaUy was valuable, from a
dislike to the individual, or to the particular school to which he
belonged. On the present occasion, there was a paper by Dr.
Trinks, that really might have been dispensed with. It came as
a flat contradiction to what had been so well and so completely
stated by the President. Indeed, the address aUuded to, so com-
pletely answered tliis paper by anticipation, that had it fallen
undor the notice of the learned foreigner, whose cases had just
been narrated, the Society might have been spared hearing a
repetition of eiTors that had been so ably refuted by Dr. Quin.
In the tli^t case that had been read, he. Dr. Drury, could give
no credit to the China beyond the good it very likely produced
by being given after Haemorrhaga In cerebral affections he had
a vtny high opinion of Hyoscyamus, and had used it freely with
groat success. A very interesting case that just came into his
mind — that of a little child w^ho suffered from several derange-
ments of vision, preventing her reading, following diphtheria, —
the double vision and other symptoms disappeared under the use
of Hyoscyamus. In the case where Belladonna was given, it ap-
peared to be indicated by the tumour, but if instead of giving
stronger doses, a higher potency had been given, a better result
might have been obtained. While using other medicines
when indicated for ovaritis, he, Dr. Drury, had the highest
opinion of the action of Conium.
Dr. Wilde (of Winchester), — I have recently seen a good deal
of scarlet fever in Winchester. In most of the cases, very severe
throat affections occurred, and in a great number hsematuria with
anasarca. I found that where Belladonna had not been used at
the outset of the disease, in consequence of my not seeing the
cases earlier, that medicine was very useful in alternation with
Arsenicum, during the nightly fever, delirium, and restlessness ^
which accompanies the anasar^ous condition. I had one very |(^
interesting case of paralysis after scarlet fever, occumng in a
A C<x8e of Paratyphlitu. 245
cliild two years of age. After the patient had passed well
through the rash and a severe throat affection, and seemed to be
rallying from the attack, 1 was sent for suddenly to see the child.
On arriving at the house, I found the little patient lying in the
lap of his mother, in a semi-comatose state, with dilated pupils,
and perfect loss of motion of the left arm and leg, with great dis-
tension and fullness of the veins of the scalp, and much heat
about the head. Belladonna was administered, but with ap-
parently no good effect. I then tried Zincmn Met, which com-
pletely removed the paralysis, and the child recovered after three
or four days.
Me. Cameron. It is with great deference to so eminent and
and experienced a physician as Dr. Trinks that I venture to call
in question the value which he sets upon the directly curative
effects of China in the cure of albuminuria and hsematuria. Not-
withstanding his authority, I own that I am very sceptical as to
the great importance of any one remedy in the treatment of
symptoms like these, which so often depend upon many and very
different pathological conditions. We know very well that albu-
minuria and haematuria are symptoms that may often arise
simply from a morbid state of the digestive or other organs, un-
connected with any structural lesion, temporary in their duration,
and that will disappear without any special treatment, while
again in other instances they denote the most incurable and
deadly structural diseases. Owing chiefly to the serious nature of
albuminuria in Bright's disease, and to the rather sweeping gene-
ralizations of that and some other eminent writers, a degree of
importance has become associated with the smallest appearance
of this symptom in any case, which it does not always deserve.
In some patients, for instance, albuminuria is readily produced
by a dose of Calomel or other preparation of Mercury. Some
people experience it after a full meal, and lose all trace of it next
day. I know a gentleman, in fair average health, who has had it
for more than twenty years. Another gentleman, who goes
through a great amount of mental and bodily work, has been
subject to albuminuria at intervals for many years, and regards
an attack of it as rather curative, as he feels better after than
before it. In short, there seems to be no reason to question the
opinion of many Pathologists who maintain that this appearance
may often depend entirely on errors of digestion of a very simple
and unimportant kind, and that in these cases the symptom is
owing to the mode in which the pabulum is presented to the
kidneys for secretion. The same general remarks apply to
hematuria — ^it is often unconnected with any local disease, arising
in such cases from a generally morbid condition of the system,
and disappearing when that condition has been removed. It
246 Cases of Ophthalmia,
frequently occurs, withoutanylesioii,in purpura, scurvy, sinall-po3t,
typhus and other low forms of disease, and, in these cases, takes
its departure without any other treatment except the general one
employed for the removal of the adynamic condition of the sys-
tem. Although these and other similar arguments cause me to
doubt the directly curative action of China in the interesting case
reported by Dr. Trinks, I am very far from calling in question the
perfect propriety of his treatment, as I believe that in the ex-
hausted state, and hsemorrhagic tendency of the patient, it was the
most appropriate remedy that could be used. I am, however,
equally persuaded that it acted by relieving the generally
adynamic condition of the patient, and not by any immediate
Homoeopathic or specific influence over the kidneys, just as it
does in cases of scurvy, purpura, or typhus, accompanied with
haematuria in removing this symptom. I cannot sit down without
expressing my regret that Dr. Eussell has been called away before
the reading of this paper. Had he been present he woidd have
explained to us what amount of importance was to be attached
to the observations of Dr. Trinks in regard to the practice and
opinions of Hahnemann at different periods of his career, obser-
vations which he believed to be entirely at variance with those
of other credible witnesses ; and he feared that unless they were
now met with a distinct contradiction, they would be admitted
unchallenged in future into the History of Homoeopathy.
CASES OF OPHTHALMIA, WITH OPACITY OF THE
COENEA.
By Dr. Ozanne.
The following cases are doubly interesting to the Homoeo-
pathic practitioner, inasmuch as they show the power of his
remedies in effecting a cure where the ordinary or classical
treatment had previously failed.
Case l. — Mary Anne Duffy, a very interesting little girl, 3
years old, was brought to the Homoeopathic Dispensary on the
14th September, 1860. About five or six weeks previously she
had an attack of measles. At first she was under the care of
one of the parish surgeons, but subsequently was trans-
ferred to that of his colleague. Before the measles had
subsided one of her eyes became inflamed. The case was
with Opacity of the Cornea, 247
treated most carefully in the usual way ; leeches were applied
twice, the child was blistered, the eye was fomented with
decoction of poppies ; and subsequently the eye was touched
every day with a small brush soaked in some medicated solu-
tion In addition to these measures internal remedies were
at the same time administered.
Notwithstanding this careful treatment, the appearance of
the eye, when I first saw it, was most alarming. The whole
of the eye-ball seemed much swollen, the conjunctiva injected
red and swollen ; the cornea was opaque, as if painted over
with a thick coating of starch, and appeared to me to be, as I
noted down at the time, ** disorganized." The child had quite
lost her appetite, and had much fallen off in flesh.
My prognosis was in this state of things, of the most dis-
couraging character, for I must confess I looked upon the eye
as irrevocably lost.
Aconitum 1, six drops in three ounces of water, a teaspoonful
every two hours.
Sept. 15. — Much pain. No change in the appearance of
the eye.
Belladonna 1, 6 drops to two ounces of water, a teaspoonful
every three hours.
Sept. 17. — ^The pain diminished. Less swelling and less
redness.
Merc. cor. 2.
Sept. 19. — Pain much relieved.
Eepeat Merc. cor.
Sept 21. — Still some redness of the conjunctiva; the pain
much better.
Aconitum for three days, six dix)ps to three ounces of water, a
desert spoonful three times a day.
Sept. 24. The eye generally much improved; the signs of
inflammation disappearing. The cornea much improved, the
ulcerations healing, and its general opacity less.
Repeat Aconitum.
248 Cases of Ophthalmia,
Sept. 26. — ^Much the same.
Merc. cor. for five days, six drops to three ounces of water, a
desert spoonful for three days.
Sept. 29. — General improvement continued. Cornea be-
coming more transparent.
Belladonna for three days, six drops to three ounces of water.
Oct 2. — Much the same.
Merc. cor. for five days.
Oct. 5. — ^Diarrhoea, many watery motions since the previous
day.
Veratrum albm. 2, six drops to three ounces of water, a
teaspoonftd every two hours.
Oct. 6. — Bowels quite well, eye better, cornea healthier and
gaining in transparency.
Merc. cor. for five days.
Oct 9. — The child had taken cold, had a cough, and redness
of the lids of the good eye. Cornea getting clearer.
Aconitum for fivei days, six drops to three ounces of water, a
teaspoonful four times a day.
Oct. 13. — Improving.
Belladonna, for three days.
Oct. 16. — Eye much improved; the opacity had so far
diminished that I could see the whole outline of the pupiL
Merc. cor. for five days.
Oct. 19. — Cornea getting more and more transparent, the
inner half being alone opalescent The eye appeared to be
more of its natural size.
Bepeat Mer. cor.
The child remained under treatment until the 10th Dec,
taking in succession Camabis Sativa 1, Aurum m. 3, Belladonna
4, Camabis Sativa 1, and Merc. cor. for five days and six days;
at the end of which course the eye was completely restored
to its original state.
The above notes are transcribed almost word for word from
the case as drawn out at the time ; they are necessarily very
with Opacity of the Cornea. 249
incomplete, but nevertheless suffice to show that the ordinary
treatment had most signally failed in every respect. It had
failed to relieve the pain, had failed to remove the inflamma-
tion, and had failed to avert the serious consequences which
result from badly-treated cases of ophthalmia, when these are
severe.
Quite recently I have had a case in every respect similar to
the above, in a little girl aged 20 months, AdaE ^ but
having been fiK)m the first under Homoeopathic treatment, the
results have been far different. By means of Aconitum 1, and
subsequently Belladonna 1, and Merc. soL, 2 dec., trit., the in-
flammation and its e£fects have been removed in a very short
time without any damage whatever to the cornea.
I may safely say that the case of Mary Anne Dufiy was one
of the worst that could be imagined, and yet the result was all
that could be wished for.
Case 2. — Sarah Cameron, aged 11, daughter of a sergeant quar-
tered at Fort George, had been from three to four weeks imder
the treatment of the Surgeon to the Eoyal Artillery. Collyria
externally, and powders internally, had been regularly ad-
ministered.
On 29th September, 1862, the lids of both eyes were red
and swollen, the conjunctiva much injected. The left eye worse
than the right.
Aconitum 1, 10 drops to 4 ounces of water, a teaspoonful every
two or three hours.
Oct. 1. — Both eyes much better.
Belladonna 3, 12 drops to 4 ounces of water.
Oct 3. — ^The improvement continued. Two patches of red-
ness in the globe of the left eye ; some excoriation of the edges
of the eye-lids.
Merc. cor. for 4 days, to be followed by Merc. soL five times a day.
Oct. 6. — Improving.
Eepeat the same.
Oct 10. — ^Much better, excepting some photophobia.
Belladonna for four days.
250 Cases of Ophthalmia,
Oct. 13. — Still a little injection of the eyes. This appears
to be kept up by exposure to strong currents of air, the Fort
being in a very high and exposed situation.
Merc. cor. for six days.
Oct. 20. — Much better.
Bepeat the same.
Oct. 29. — Eight eye much inflamed (a most decided relapse).
Aconitum 1, 8 drops to 4 ounces of water; a teaspoonful every
three hours.
Nov. 1. — Eyes better. I now detected a small ulceration in
the comer of the right eye. Whether it existed previously or
not I could not feel sure, as untU now I could not make so
thorough an examination of the cornea as I could have wished
Mer. cor. 2, 10 drops to 4 ounces of water.
From this date the medicines given were Mer. cor. 3 and 5,
Aconitum for 3 days for another relapse on the 29th November,
and SUicea 5. On the 26th December the eyes were perfectly
well.
Since then Sulphur 5, 2, and 12 have been prescribed for a
herpetic eruption on the occiput.
This case, although not a severe one, is interesting on account
of the failure of the Allopathic treatment, and of the manifest
improvement which soon took place under the new treatment;
and the final cure in the most unfavourable season of the year
and under unfavourable circumstances.
Case 3. — A. — , a delicate young woman, aged 16, was
brought to me on 28th November, 1862.
She had been affected with ophthalmia over nine weeks. At
first there was very much pain, photophobia and lachrymation.
She was at once placed under the care of an Allopathic surgeon,
who, in addition to a course of medicine internally, applied
blisters on the temples, and subsequently instilled caustic solu-
tion into the eye.
When I first saw her, there was so much pain in the eyes
and photophobia, that it was impossible to ascertain the state
with Opacity of the Cornea, 251
of the comea of either eye. She informed me that at first
" everything before her eyes looked like fire," then everything
became quite dark. For about a week she could see the light
of day, but as if through a thick cloud.
Belladonna for 2 days, 12 drops to 6 ounces of water, a dessert-
spoonful every four hours.
Dec. 1. — Her mother reports that she cotdd open her eyes a
little yesterday, and bears the light of the candle better.
Shooting pain in the nose.
Bepeat Belladonna for 2 days.
Dec. 5. — ^A cold and cough. Eyes much the same they say,
but bears the light better, and can open the eyes better.
Belladonna for 5 days, 12 drops to 6 ounces of water, a dessert-
spoonful every four hours.
Dec. 9. — I saw her this day and was able to examine her
eyes carefully, as she was able to open them. I found the
comea in each eye quite opaque. She was able to see the
shadows of objects, but could discern nothing.
Mer. cor. 2, 6 drops in 8 spoonfuls of water, a spoonful
every four hours.
Dec. 11. — StiU a cough. Sight improving. Last evening
could see her own fingers, but they appeared very dark in
colour, and much larger than naturaL
Mer. cor. 2, 12 drops to 6 ounces of water, a dessert-spoon-
ful every four hours.
Dec. 15. — Sight continues to improve, and the comea is
getting clear. White objects appear yellow to her, and brown
seem to be black. Some toothache since the 13th.
Aconitum for 1 day, 8 drops to 4 ounces of water ; a dessert-
spoonful every two hours.
Dec. 18. — ^Toothache better. She can see smaller objects.
Mer. cor. 2, 12 drops to 6 ounces of water,
Dec. 20. — I called to see her, and found the right comea
262 Cases of Ophthalmia,
still very opaque, but the left more transparent, especially at its
upper part.
Eepeat the Mer. cor.
Dec. 22. — Much the same.
Silicea 5, 12 drops to 6 ounces of water; a dessert-spoonful
four times a day.
Dec. 26. — The sight continues to improve. She is now able
to see objects and to recognize them, though not distinctly
Bepeat Silicea 5.
Dec. 30. — Continues to improve.
Merc. cor. five times a day, as before.
Jan. 5. — ^The improvement continues ; she is now able to see
a little with the right eye.
Silicea 5.
Jan. 9. — Improving.
Mer. cor., four times a day.
Jan. 13. — Improving.
Silicea 5.
Jan. 21. — ^Mer. cor., five or six times a day.
Jan. 26. — ^The right eye is getting on as well as the left.
Her mother says that she can see wonderfully better, having been
able to discern her face, and to read aU the letters on a placard
in the street.
Silicea 18 ; 6 drops to 6 ounces of water; a dessert-spoonful
four times a day.
Jan. 30. — ^A slight cold, with slight vascular injection of
the right eye.
Belladonna, for three days.
Feb. 6. — Much the same.
Mer. cor., for six days.
Feb. 10. — ^Eyes keep improving.
Gale, acet 12.
Feb. 16.— Going on welL
Bepeat the Calc. acet.
with Opacity of the Cornea. 253
Although not completely recovered this case is one of the most
interesting I have met with for a long time. The cornea of
the left eye is very nearly transparent throughout, and that of the
right eye in a fair way towards a complete cura The patient
can now distinguish the lines o£ impression in an ordinary book^
but cannot distinguish the letters.
The gentleman who attended her at first called soon after I
commenced the treatment, tasted the medicine she was taking,
and declaring that there was nothing in it ; at the same time he
announced that he would become a believer in Homoeopathy
if the patient ever recovered her sight by means of it.
Whether he ftdfilled or not his announcement it matters but
little, at any rate, this is certain, that notwithstanding his skill,
neither the pain nor the photophobia were relieved by the
orthodox measures he employed, but that an improvement began
soon after the commencement of the Homoeopathic course, and
has progressed up to this time in a surprisingly rapid manner.
On looking over the medicines prescribed in these cases I find
that Aconitum, Belladonna, and Mercurius Corrosivus have been
those almost exclusively employed. In one case Cannabis sativa,
and in two Silicea.
I have the greatest confidence in the low dilutions of the three
first of these medicines in the acute cases of disease of the
cornea, followed by ulceration and subsequently by opacity,
but experience has taught me the value of higher dilutions of
Mercurus corros., and of SUicea in the more chronic forms. The
latter medicines I prefer usually at the 12th, 18th, and 30th
attenuations.
In cases of ophthalmia of a more violent type, with more
inflammatory irritation, and in strong constitutions, I generally
use the lowest dilutions of Aconite with Belladonna, and Mercu-
rius solubilis in preference to the corrosive sublimate. The
solubilis is conveniently administered on the 2nd or 3rd decimal
attenuations ; th^ dose a grain twice or three times a day
generally alternated with Belladonna.
254
SOME UNPUBLISHED LETTEES OF HAHNEMANK
To Dr. Stapf.
Koethen, August 5th, 1830.
Dear Friend and Colleague,
The accompanying communication is for the meeting of
the 10th of August. May I request that it should be read
slowly, and that you will give in the coming Archiv, -a report
of the Congress along with this paper of mine, which is thus
at your service ?
Will you also, after this essay, lay before the meeting this
anonymous communication, which, I think, wOl be of use?
there will be those present who will understand the meaning
of it. Joking apart, the homoeopathic physician must at last
come to this, that he gives only the needful medicine without
any vehicle ; in that way he wiU evade aU attempts of the
criminal jurisdiction to hinder his dispensing his own medi-
cines. Yours,
Samxtel Hahnemann.
It would be well to remind the meeting that, in treating
all cases, we should as far as possible ascertain what allo-
pathic medicines the patients have taken in large doses, such
as sulphur, carbonate of soda, that they may avoid them.
To Dr. Stapf.
Koethen, Dec. 27th, 1830.
Dear Friend and Colleague,
I send you with this one globule of Natrum, M. 30th,
for Miss Eliza, and one globule of Calcarea, 30th, for Miss Mary,
who, however, has not given me a sufficiently minute account
of her symptoms. I want to know about the headache last
Unpublished Letters of Hahnemann, 255
week, the sleeping of the limbs and the whole side, the sore
throat, the hsemoptysfe, and cough, as well as the swelling
of the glands, and the cold feet. The next time she writes, I
beg she will be more particular ; however, on the whole I am
pleased with both.
Dr. E. Aegidi was the one whom I also preferred for the
Princess. I thank you for having obtained the situation for
him.
It certainly has a bad appearance, that the unequivocal testir
mony in the journals of the marvellous efficacy of Homoeopathy
(especially Veratrum) in the cholera has not found entrance into
the ears and eyes of the rulers, particularly Nickolus ; but there
is no doubt that it must ultimately do so. The great and infi-
nitely good Spirit, who cares for the fate of the lowest insect,
will, with mighty hand, in the stillness of His power, without
our being able to see how all co-operates for the end, take
advantage of the great opportunity which so directly affects the
welfare of those smitten by illness, hitherto so sadly neglected.
The present system of medicine is really a disgraceful patch-
work. Eead, for example, how Hasper, the nephew of Kreysig,
in Leipsic, in the face of the Homoeopathists, teaches that the
cholera should be treated with blood-letting to 30 ozs., with
leeches, and 3 or 4 drachms of Calomel ; grounding this mur-
derous recommendation upon theory, and what he calls the
experience of the best physicians — ^that is, the English. Is it
not enough to rouse into an outbreak the rage of the Homoeo-
pathists ? I should like if Attomyr were a man who would
raise a powerful voice against the allopathic murders, for the
reviews of allopathic stuff which have hitherto appeared in your
Archiv, seem to me to be done with too lenient, mild, and gentle
a hand, to shake out of their security the obdurate and scanda-
lous blockheads. For such a case, the cautious, timid stroking
of our homoeopathic reviewers won't do ; they look as if they
were going to attack a fly. Can it be worse with us than that
we shoxQd be deprived of our natural rights as citizens, and shall
256 Unpvhlished Letters of HahnemanrL
we not scream into their ears the^ wrongs they do, and pursue
the murderous host with stabs of our only weapon, the pen.
They must learn to be afraid of having their malpractice attacked
by us ; they must tremble before us, otherwise we shall make
nothing of it, and our immense superiority will not be recog-
nised ; otherwise we shall not be honoured, nor wiU they be
brought into the public contempt and abhorrence which
they so richly deserve. I must beg of our fellow-workmen
to rouse them better for the work, to kindle their zeal,
to bring into clearer light the advantage of our heavenly
art, by more vigorous defence and attack, and to expose
the miserable nakedness of these men-slayers. Were I but
thirty years younger, I would alone engage them, and none
should escape my deadly strokes, I would not stop till I
had silenced every one of their miserable organs. Now, I
ought to think how I can leave this duty to abler disciples.
After I have finished my 76th year, I am no longer able to
enter the ring. I have, I believe, with immense efforts, placed
my science upon pillars which can never be overthrown. But
to drive the haughty and slanderous intruders out of the temple
of -^sculapius with scorpion scourges, less will not suffice —
ought not to be laid upon me. Would to Gk)d a man should
arise with a head, a heart, and powerful arm, who would devote
his Ufe to this second and important work as I did to the first
— ^the establishment of Homoeopathy ! Give my greeting to
Attomyr.
I send you along with this the Hungarian translation of
the "Organon" and the first part of my " Materia Medica."
For GuiUon's good wishes, thanks from my whole souL
Up let us raise our head. If we do not conquer and beat to
the ground our and mankind's enemies, the fault is ours ; even
now, when all is movement, and every ear and eye upon the
stretch, it is the time to begin and carry something through.
My spirit is with you.
Samuel Hahnemann.
Unpunished Letters of Hahnemann. 257
To Dr. Staff.
Koetlien, Feb, 3rd, 183L
Dear Friend and Colleague,
Make your promise good, and use the delightful railway
to give me the pleasure of a visit ; but remember you must
bring our friend Eummel along with you.
So you will not wear the splendid ring ? Are there not true
friends, who are far removed from envy, and who rejoice heartily
and truly with you over the happy circumstance ? Would it
be well to deprive such friends of such a pleasure, and not to
show them this gem in which they had a share. I feel that I am
such a friend to you, for a gift to you is a pleasure to me ; and
you may trust that there are many of the same sentiment. So
you must put on your ring when you go to visit a true friend,
that you may rejoice him with it. And yet the letter the
Duke wrote with it, is worth double the value of the jewel ;
but this excites no envy in your friend, but gives him as much
gratification as if the letter were addressed to himself. So you
may know how to act in such a case — and you will put on
your ring for the sake of your friend. I send you ^gidi's
letter. I found it necessary to show it to the princess, and I
have done him good service by so doing ; for the prince imme-
diately appointed him to a Hussar regiment, then vacant, under
General Von Wiebel, which I have communicated to ^gidi. I
am very glad of this piece of good luck ; for besides such a
post in so populous a town, under the protection of its ruler,
he may carry on his homoeopathic practice without let or hin-
drance fix)m any man — preparing and distributing his medicines
as he pleases. If this is not incredible good fortune for a
homoeopath, I know not what is. He will also enjoy the favour
of the princess, although I continue to be physician to her.
I have only had time within these few hours to look at the
new number of the Archiv, which you were kind enough to
send me. The article of Miiller, the only one I have read,
17
258 Lecture by Dr. Russell on Epilepsy,
speaks of me in such a tone, that I must shortly write him a
letter of acknowledgment. Thus must we step out, imless we
are to be prepared to be trodden to pieces. He has won great
creat credit to himself by this article. Do you know anything
of ? I hear nothing. Hermann, of Petersburg, who had
to do with his family, writes to me without being asked, that
he is a pitiable shaking reed. I do not know how better I
can say it. Hermann has just married my neice, the youngest
daughter of Trinius, of the Academy.
Yours, Samuel Hahnemann.
^ /»r LECTUEE ON EPILEPSY.— Lecture II.
By De. RusslELL.
Gentlemen,
I propose in this lecture to confine my observations to
the treatment of Epilepsy. The success hitherto obtained
by the most careful and scientific practitioners, accord-
ing to the old school-method, has been very xmsatisfactory.
Out of 115 cases of chronic convulsive diseases treated by
Dr. Reynolds, all of which in common parlance would have
been entitled Epilepsy, and had been treated as such for many
years, 21, or 18 per cent, were cured. Of these, however
only 80 were true Epilepsy, and the number of recoveries out
of these 80 were only 8, or 10 per cent. Out of 191 cases
treated in this Hospital, 38 are reported as cured, or 20 per
cent. But as these cases are chiefly among the out-patients
there is always considerable uncertainty in regard to the re-
sults in a disease which may be long dormant without being
radically cured. And under the head Epilepsy, it is not iln-
probable that other forms of convulsive diseases may have
been included, as in Dr. Reynolds's first list. There is no
Lecture by Dr. Russell on Epilepsy, 259
great difference in the results, judging by these tables of the
old and new system. At all events, whether we excel our
neighbours or not, we have no ground to boast. So long as we
have to record the mortifying fact, that four-fifths of the epi-
leptic patients who have been treated by us have not been
cured; and if any one can discover more certain indications
for the remedies most commonly used, or suggest any means
not hitherto employed, and which hold out any prospect of
advantage, he will be hailed as a benefactor of his kind.
In considering the treatment of EpUepsy, the subject na-
turally divides itself into general rules for the guidance of
patients, so that they may be fortified against the consequences
of the disease, and the special indications for the administra-
tion of remedies.
In regard to the first, or the general management of epileptic
patients, there is a great difference of opinion as to the proper
food; one party strongly advocating a low diet, excluding
animal food and forbidding all stimulants ; while another party
insists upon what is called a generous fare and a liberal allow-
ance of wine. Those who adopt the latter view, argue that we
are apt to be deceived into the erroneous idea of spasms being a
manifestation of excessive nervous force ; while, on the contrary,
their presence invariably indicates an enfeebled condition of the
nervous system ; — that we meet with them as consequences of
loss of blood and of impaired vigour generally, and that the
restlessness of a nervous patient is not from too much, but
from, too little life. Especially it is pointed out, that the
scanty vitality of epUeptics is betrayed by the general coldness
of the extremities, and the small, quick, and jerking pulse.
And that it is in consequence of this low condition of what
we may call the power of the Anima, that persons afflicted
with Epilepsy become subject to cosmical influence. That, in
fact, they approach the life of plants as they recede from that
of man. " The plant," says Dr. Eadcliife [Epilepsy and other
Conytdsive Affections. By Charles Bland Eadcliffe, M.D. 2nd
260 Lecture hy Dr, Russell on Epilepsy,
ed., 1858, p. 142], " exhibits plainer and more numerous evi-
dences of periodicity than the animal ; and it does this, I argue,
because it has less of the innate life which enables man and the
higher animals to be partially independent of the sun and other
vivifying influences which act upon them from without ; and
hence it follows (this among other reasons) that the man who
exhibits more evidences of periodicity than he ought to do,
has been shorn of some of that innate life which is the badge
of destinction between him and the plant." Whether or not the
want of the power of the Anima brings the epileptic under the
influence of the moon, has been keenly debated, and some of
our most recent and most scientific writers declare themselves
on the side of the moon. " Although here and there," observes
Eomberg [vol. ii. p., 205], "doubts have been raised against
this view, the accurate observations of others have estabhshed
its correctness." Among these observers a prominent place is
always given to Dr. Mead, who, in the following words, de-
scribes a celebrated case of lunar influence. " No greater con-
sent in such cases was, perhaps, ever observed than what I saw
many years since, in a child about five years old, in which the
convulsions were so strong and frequent, that life was almost
despaired of. . . . The girl, who was of a lusty, full habit of
body, continued well for a few days, but was, at full moon,
again seized with a most violent fit ; after which the disease
kept its period constant and regular with the tides. She lay
always speechless during the whole time of flood, and recovered
upon the ebb. The father, who lived by the Thames side, and
tiid business upon the river, observed these returns to be so
punctual, that not only coming home, he knew how the child
was before he saw it; but in the night has risen to his
employ, being warned by her cries, when coming out of the fit,
of the turning of the water. This continued fourteen days —
that is, to the next change of the moon." This case is gene-
rally quoted as demonstrative proof of the moon's power.
Perhaps it would be more correct to accept it as evidence of
Lecture by Dr, Russell on Epilepsy, 261
general cosmical influence, for it may have been, that it was not
any direct effect of the moon upon the nervous system of this
child, but of the ebbing and flowing of the waters of the
Thames^ We now know that it is held by some of our highest
authorities, that the molten lava which underlies the habitable
crust of the globe — ^the waters of fire under the earth — flow
and ebb in their outlets — the volcanoes, just as the waters of
the ocean above the earth, swell and retire in obedience to
tidal laws.
How much we are all under cosmical influences, is every
now and then shown, when an earthquake happens, or a
new epidemic sweeps over a tract of a country, cutting down,
as with a scythe, all who have not enough of vital power in
them to resist its fatal force. The weak perish, but all, even
the strongest are affected. The most sensitive are aware of it
at the greatest distance. A curious illustration of this is men-
tioned in Eckermann's Conversations with the Poet Goethe,
who, although one of the most sensitive, was, at the same time,
one of the most robust of men — a great example of that rare
nature, which, like our own Shakespeare, felt everything, and
was subdued by nothing. One night Goethe rang for his ser-
vant about midnight ; when the servant went he found that
Goethe had moved his bed to the window and was gazing upon
the heavens. Goethe asked him if he had seen nothing re-
markable in the sky ; on receiving an answer in the negative,
he desired the man to enquire of the watchmen if they had.
They had not. On his servant's return he found his master
still in the same position, and he made this remarkable an-
noimcement: "Listen," said Goethe, "this is an important mo-
ment, there is now an earthquake, or one just going to take
place." Next day he mentioned at Court (Weimar) his con-
viction, and the duke believed he was right, from his know-
ledge of Goethe's character. Some weeks afterwards the in-
telligence arrived at Weimar that upon that night the great
earthquake had taken place at Messina, which had overthrown
262 Lecture hy Dr. Russell on Epilepsy.
a great part of that city. Here we have an example of an
impressionable man perceiving a telluric influence unfelt by his
fellows. He perceived it, but merely as a sensation, from
which he drew his inferences ; for his nervous system was in a
state of health. But if it had been in an epileptic condition,
would this impression not have most Kkely given rise to a fit ?
We have positive proof afforded by the experiments of Dr.
Brown-S^quard, that, while on the one hand an injury of the
centre of the nervous system is a predisposing cause of Epil-
epsy, that on the other hand the exciting cause is an impres-
sion on the extremities of the nerves in communication with
this morbid centre, and that so long as this part of the peri-
phery is not affected, the Epilepsy may slumber' for almost any
length of time.
The most important general indications in the treatment of
Epilepsy are discovering how, in each case, the strength of
the patient can be best sustained. Some thrive best on a
nearly purely animal diet; some on a merely vegetable one;
others on a mixture of the two. We must find out by careful
investigation, which agrees best, and that we must order. The
same rule holds good as regards stimulants ; to some they are
injurious, to some beneficial, and to others indifferent. The great
error seems to be, laying down any general rule for Epileptic
patients. There is, and can be, no such rule. Each case must
be treated on its own merits, and diet should be as specific as
treatment. It is a consequence of 'this vague generalization,
that it is the fashion to order iron, and^^so called tonics, in
Epilepsy. The pmctice, although recommended by so high an
authority as Dr. Watson, is emphatically condemned by Dr.
Brown-S^quard. The action of iron on the brain he considers
injurious. The same rule, or rather the same latitude and
absence of rule, which directs us best in i-egard to diet, would
be good in respect of exercise, and indeed of every one of the
conditions of healtL In a case of Epilepsy, we must carefully
examine into all the habits of the patient, and insist upon the
Lecture ly Br, Rtossell on Epilepsy, 263
avoidence of everything which can either damage or enfeeble
the general health, and tend to give special animation to any
exciting cause of a paroxysm. Above all things, we should
have the patient avoid all sources of irritation of the surface of
the body, being taught by physiology how the sensitiveness
of the peripheral nerves is exalted by the epileptic condition ;
and it is rational to expect benefit from soothing ablution with
cold or hot water, and the application of soap or oil to the
surface of the body. The effect of soap-water — a common ex-
pedient in the water-cure establishments — in relieving an over-
sensitive condition of the skin, is most marked, and may be of
great use in the treatment of Epilepsy. What an Epileptic
wants is strength within and hardness without. The great
source of inward strength is food and exercise, and of outward,
hardening friction and proper baths. If we can discover any
particular spot where the aura (if there is an aura) takes its
rise, we may be tempted to try the effect of a local anaesthetic
upon it. The best is probably that recommended by Dr.
Brown-S^quard, and consists of half-a-grain of Sulphate of
Morphia, and one-sixtieth of Sulphate of Atropia, and a minim
of dilute Sulphuric Acid in fifteen minims of water. This is
to be injected under the skin of the part where the aura origi-
nates.
It is now clearly established that weakness of a muscle, or
set of muscles, predisposes it to be affected with spasmodic
action. Dr. Brown-S^quard, in a lecture recently delivered in
this neighbourhood, and reported in the Medical Times and
Qaaette of March 28th, observed that "of two muscles, one
atrophied and one healthy, the former will respond to a cer-
tain stimulant, while the latter will not ; a weak person will
jump or start on hearing a noise, which produces no effect upon
a strong one." This he attributes not to " weakness of nerves,"
as it. is called, but to the weakness of the muscles. Epileptics
are usually very weak, often partially paralysed ; their reflex
excitability is augmented, while their voluntary muscular
264 Lecture hi/ Dr, Russell on Epilepsy.
power is diminishei Here, then, we have one of the most
important of the general indications for ti^atment — yiz., the
adoption of means to increase the voluntary power of the
muscles. Nothing is better for this than gentle drilling, or a
course of what is called medical gymnastics. I have known
cases of Epilepsy very much benefited by the treatment
known by the name of " the Movement Cure."
To sum-up, an epileptic patient should be nourished with
the greatest care, so as to bring the whole body into the highest
condition, but especial attention should be paid to the develop-
ment of the muscular system, and this should be exercised in
such a way as to improve the control over the limbs. Thus,
dancing, marching, and all movements which tend to curb the
loose shambling gait of the epileptic, are of importance to his
cure. Besides, great care sHbtild be bestowed in bringing the
skin into a healthy state, by baths and by friction, 'so as to
allay all morbid sensitiveness, which is apt to be the starting
point of the train of mischief, which ends in a paroxysm.
These are the obvious suggestions made by common sense upon
the facts ascertained by modem physiology, in regard to the
causes of EpUepsy ; at the same time it is right that we should
bear in mind that we ^hall often meet with epileptics who
are in perfect bodily health, and well developed. Dr. Eeynolds
lays down as inferences from a large series of observations : —
That Epilepsy is not incompatible with perfect physical
health.
That it is the exception, not the rule, to find serious impair-
ment of the organic constitution.
That the co-existence of Epilepsy with extremely robust
health, is more common than the converse.
How far Dr. Eeynold's observations justify such sweeping con-
clusions I cannot say, but certainly several of the cases that have
come under my own treatment have been persoHS in whom I
never should have suspected any infirmity of any kind, judg-
ing from their appearance.; and in this class of patients we
Lecture hy Dr. Russell on Epilepsy, 265
cannot expect to do miicli good by any general, dietetic, or
regeninal management, and must confine our expectations to
producing a change in the system of the patient by a st.eady
course of medical treatment.
The treatment of Epilepsy by medicines naturally divides
itself into those which are best adapted to arrest the first
stage, and those which tend to mitigate the paroxysms, and
prolong the interval between the attacks.
There seems no doubt that the first stage of an epileptic
seizure may be arrested, just as the first stage of Cholera is, by
Camphor. I have witnessed this in Cholera. I once saw a
little girl of about eight years of age literally take Cholera.
She was in a room where there were two patients in a state of
collapse. She suddenly gave a slight cry, and on looking at
her face I saw the immistakeable, but indescribable change,
which indicates the invasion of Cholera. This is a well-known
fact in regard to Cholera. In the instance referred to, I im-
mediately gave the patient a dose of Camphor which I had in
my hand. The effect was instantaneous. I watched th^ life
returning into the face, which before had been the countenance
of a corpse. It came back slowly and steadily, the pulse was
extremely rapid and small ; it increased in volume, and abated in
speed, and" in about ten minutes the danger of death was passed.
The same rapid arrest of an epileptic paroxysm is sometimes
effected. " Once," says Dr. Eeynolds, " when I was talking to
an epileptic; and observing his eye, a fit commenced ; the eyes
rolled upwards, and to one side, and the pupils dilated. He
had, however, after this dilatation sufficient power to say, " I am
going to be ill," but not till then did the distortion begin.
This attack was stopped by Chloroform. Similar attacks in
other patients have been arrested by placing Ammonia near
the nostrils. But neither Ammonia, or Chloroform or anything
else, has the slightest effect after the first moment of the
paroxysm.
This first stage of Epilepsy is probably caused by contrac-
266 Lecture h/ Dr. Russell on Epilepsy,
tion of the blood vessels of the brain proper, and of the face,
and tonic spasm of the muscles of the eye and face. The effect
of Ammonia and Chloroform upon this spasm is very much
like that of the smoke of Strammonium upon the asthmatic
spasm, and immediate relief is the consequence. Considering
that upon the arrest of this first stage so much depends, and
that in some respects it is so easily managed, it seems singular
that it should so seldom be effected. The reason is, that this
stage is so very short, lasting not above a few seconds, and
that even these few seconds have somewhat deprived the
epileptic person of his power of thought and action. It is
just possible that there may have been real virtue in some of
the amulets that were so highly prized even by the least super-
stitious of the ancient physicians in the treatment of Epilepsy.
Possibly certain substances worn round the neck, so as to give
off their fragrant or pungent particles in the immediate neigh-
bourhood of the extremities of the branches of the nerves that
supply the lips and nostrils may have had a good effect in
arresting the first stage of Epilepsy; and it may be worth
while to try the effect of a bag of Camphor suspended round
the neck, such as it was the custom for persons exposed to Cholera
contagion, to wear.
If, however, our efforts to arrest the first stage fail — and for
my own part, I have never seen them succeed — then we must
address ourselves to the task of discovering some medicines
which so act upon the seat of the disease as to restore it to
a normal condition, that is, which have the power of reducing
to their natural calibre the capillaries of the spinal chord and
brain, and thus of removing that preternatural excitability,
on which it now seems pretty certain that EpUepsy depends.
On entering upon this the most important and most diflficul*
portion of our task, it is well that we should clearly perceive
on what the difficulty depends. It arises in a great measure
from the conflicting testimony in regard to the efficacy of par-
Lecture by Dr. Russell on Epilepsy, 267
ticular substances, a difficulty always great in medicine, but un-
usually so in a disease like Epilepsy, which is so uncertain in
its course as to baffle the most careful efforts of the least
unbiassed to arrive at positive evidence in regard to the
utility of any given drug. When we read the works of recent
writers we are struck with the acumen they display in their
critical demolition of the statements of their predecessors and
contemporaries. For example. Dr. Eadcliflfe analises Trouseau's
cases cured by Belladonna, and reduces the number to 20 out
of the 150 patients treated. From Dr. Eadclifife we expect
some statement of his own success which shall be unassailable
by the process he brings to bear upon Trouseau. Dr. Eadclifife
is an advocate for the employment of Naphtha, Musk, and
Castor, and we eagerly look for the proofs of his confidence.
What does he give us ? "I think, he says, also, I can point to
at least a score of cases in which the fits have not only been
lessened in severity by being deprived of their most ominous
character — Coma; but where the intervals between the fits
have become so lengthened out as to aflford good ground for
supposing that the fatal habit may be altogether broken by a
continuance of the same method." If Trouseau, instead of a
detailed account of all the 150 cases which he had treated
with Belladonna, had said he thought he could point to some
scores of patients who had been benefited by this remedy, how
mercilessly would Dr. Eadclifife have commented upon the dif-
ference of Trouseau's thoughts or impressions, and the pos-
sitive testimony demanded by science before she can adopt the
conclusion that Belladonna was the real instrument of cure !
I do not make these observations to discredit Dr. Eadclifife,
for whose labours I entertain the highest respect, but to show
how miich easier it is to attack the positions of another than
to place one's own so as to secure them from being taken
by a similar assault.
What we observe in regard to the therapeutics of Epilepsy
is one of two courses, either an empirical confidence in certain
268 Lecture hy Dr. Riissell on Epilepsy,
remedies without a corresponding pathological collateral security,
or conjectural measures derived from inferences drawn from
pathological speculations, and as yet unsubstantiated by the suc-
cessful adaptation of these hypothesis into actual practice.
Nor are these obscuring conditions peculiar to either the old
or the new school of medicine. For example — on the occasion
of a paper being read before the Medico-Chirurgical Society,
Sir Charles Locock (the President) remarked that in Epilepsy,
in which the paroxysm had a tendency to assume a periodic
character connected with menstruation, he had been led to try
the Bromide of Potassium, by an observation made by a German
physician that this medicine produced temporary impotence.
Sir Charles stated that he had treated fourteen or fifteen
cases of Epilepsy presenting this peculiarity with Bromide
of Potassium, and that he had only failed to give relief in one
case ; and that one of the cases so cured had lasted nine years.
[Medico Chirurgical Transactions for 1857.]
T call this an example of an empirical cure ; for we cannot
admit, that because a German physician observed impotency to
follow the administration of Bromide of Potassium, that therefore
this substance was specifically adapted for the treatment of what
may be called Catamenial Epilepsy. However, as an empiri-
cal remedy it may be worthy of our attention, and the fact
that so accurate an observer as Sir C. Locock testifies to its
utility, is certainly a strong recommendation to examine its
claims by the light of our therapeutic law. As yet we have
not such a proving of the Bromide of Potassium as to enable us
to put it to this test. Other examples of purely empirical reme-
dies resorted to largely by the practitioners of the old school of
medicine (which affects such pharisaical contempt for the means
it so frequently condescends to employ, are the following: — .
Viscus Quercinus, or Mistletoe, [On Epilepsy and the use
of Viscus Quercinus, by Henry Eraser, M.D.] Cotyledon Um-
bilicus, and Indigo.
Of Viscus Quercinus, Dr. Eraser reports that out of 11
Lecture ly Dr. Russell on Epilepsy, 269
cases of Epilepsy which he treated with this substance 9 were
cured, one was moribund and one died.
Indigo was employed in Epilepsy first by Dr. Ideler, of
Berlin, and subsequently by Dr. Eodrigues (Eevue Medicale,
April, 1855). It is rather remarkable that although Indigo is a
remedy introduced into the Homoeopathic therapeutics, it should
not be included in the list of medicines which Dr. Laurie gives
as suitable for the treatment of the various forms of the
disease — although this list embraces no less than 46 of our me-
dicines. Certainly the chapter on Epilepsy in Laurie's " Elements
of the Homoeopathic practice of Physic," must impress our old
school medical colleagues with the enviable richness of our re-
sources ; and at the same time excite a wholesome respect in
the minds of laymen for any human intelligence which knows
how to use as arms of precision nearly half a hundred dif-
ferent weapons.
Cotyledon umbilicus, like the two former substances, has its
admirers and defenders. It, too, has been " proved" by one of
our body. But the proving has not induced its reception as
one of the accredited Homoeopathic remedies.
I have now given illustrations of the empirical remedies
recommended by high authorities in the old school, — simply on
the ground of their approved usefulness. If this were ad-
mitted, then we should not cavil at the absence of a satisfac-
tory explanation of their mode of operations. But unfortunately
there is not one of the specifics in vogue for the treatment of
Epilepsy, that has not a much larger number of deniers than
of believers, and as the number of such specifics is so numer-
ous, that their bare enumeration would fill a respectable vo-
lume, it is clearly hopeless to attempt by the simple empirical
method of experiment, unguided by theory, to determine
whether any of them have really the virtues with which they
have been accredited. Nor is there better chance of success, if
we pursue the opposite method, and, if having accepted the
pathological doctrines now in fashion as the basis of our treat-
270 Lecture hy Dr. Ru$sell on Epilepsy,
ment, we administer medicines in obedience to them alone ;
for the whole history of medicine, if it shows anything, proves
this — that every age supposed it had arrived at the long-
coveted knowledge of the real and essential cause of disease.
Now it is a poison, formerly it was a spasm, and against the
spasm an anti-spasmodic was prescribed, and after the world
had been on the strength of this doctrine swallowing anti-
spasmodics for a quarter of a century, up rose some clever,
bold man, who denied with such force, and argued with such
cogency, against the notion of a spasm having anything to do
with the matter — that the world voted itself in the wrong, and
gave up taking any more anti-spasmodics. There seems a
danger of our falling again into this error. The observations of
anatomists and physiologists in regard to Epilepsy are very
important, and their speculations as to its cause very ingenious,
and possibly true. But let us remember that there is no theory
which lias yet been universally received by all physiologists,
and that the most approved at present has not stood the test
of twenty years ; while on the other hand the symptoms of
Epilepsy have been carefully noted for as many centuries, and
if we acknowledge the sufficiency of our therapeutic maxim
as a guide in other diseases, there is no reason why we should
discard it here. Let us, then, not be led astray from the study
of the symptoms of Epilepsy into the speculative region of the
cause of these symptoms. At the same time let us carefully
arrange these symptoms, so as show at once both their natural
sequence and their comparative importance, and then try
whether we can exhibit any medicinal actions having a similar
sequence, producing similar results, and if so, whether the sub-
stances that do so ever cure Epilepsy.
In limine, let us observe that any medicine which is to
affect a radical change in the condition of an Epileptic nervous
system, and not merely arrest the propagation of the exciting
cause, must be one endowed with powers of long duration.
For this reason, I do not believe in the cures of Epilepsy said
Lecture hy Dr, Russell on Epilepsy, * 271
to be effected by Musk and Castor, and science demands of
Dr. Eadcliffe something more exact and definite than his state-
ment to the effect, that he could point out, at least, a score of
cases which had been practically cured by these fugitive
remedies.
Let us now arrange the symptoms in the order of their oc-
currence, putting down only the invariable, which we may
presume to be the essentiaL
1. Dilatation of the pupil of both eyes.
This takes place lefore there is any loss of consciousness, and
is therefore not dependent upon general insensibility.
2. Paleness of the face.
3. Twitches of the muscles of the eyes and face.
4. Loss of consciousness.
5. Tonic contraction of the laryngeal and expiratory
muscles.
6. Cry.
T. Tonic contractions of the muscles of the trunk and limbs.
8. FalL
9; Dark purple hue of the face.
10. Asphyxia.
11. Clonic convulsions everywhere.
12. Coma.
13. Sleep.
We have no right, on the Homoeopathic principle, to expect
any medicine to be effectual in the cure of Epilepsy, unless its
pathogenesy covers all these symptoms. But this is not
enough — it must also be capable of inducing a permanent
derangement of the functions of the brain and other parts of
the nervous system, as indicated by some impairment of
memory and apprehension, by a tendency to muscular feeble-
ness, and by a general habit of slight spasmodic action, repre-
sented by a the " starts," faintness, momentary arrest of con-
sciousness, &c, which constitute the most important inter-
paioxysmal phenomena. We should also like to find, in our
272 Lecture hy Dr. Russell on Epilepsy.
medicine, the power of producing somnambulism, which, as we
have seen, has a strong resemblance with some well-marked
Epileptic conditions.
Let us now examine by the proposed tests our Homoeopathic
medicines. Balladonna fulfils the first condition we have
laid down as essential It is a medicine of long enduring
action. On this head Hahnemann observes : — "In the smallest
imaginable dose, when the symptoms of the disease make
Belladonna the suitable remedy, it proves curative in the most
acute cases ; but, on the other hand, it is not less potent even
in the most chronic cases, and in them the effect of one dose will
endure for a period of three weeks, or even more." On this
point I believe that there is no difference in the opinion of ex-
perienced practitioners of Homoeopathy. Few medicines pro-
duce more enduring effects upon the animal oeconomy than
Belladonna.
1. Of its power to dilate the pupil nothing need be said.
Belladonna is the mydriatic.
2 & 3. Paleness of the face, and twitches of the muscles of
the eyes and face.
We have these symptoms accurately reproduced in Hahne-
mann's proving.
170. Distorted features.
171. Paleness of the face.
174. Sudden paleness of the face lasting some time.
4 & 5. Loss of consciousness, and tonic contraction of the
lar}^ngeal and expiratory muscles.
In a case reported by Dr. Gray, of New York, we are told
" that the patient's manner was apoplectic, respiration anxious,
and attended with brazen stridulous sound." He afterwards
speaks of it as a state of " partial coma." The narcotising
power of Belladonna, and especially of its alcaloid atropine, is
too well established to require further illustration. What
makes Belladonna especially suitable for Epilepsy is the mix-
ture of sjonptoms of stupor and spasms at a stage of the
Lecture ly Dr. Russell on Epilepsy, 273
operation of the drug prior to the production of the true coma.
In this patient of Dr. Gray's, for example, the state of coma
alternated with paroxysms of uncontrollable tendency to motion
and rapid automatic movement. Here we have an exact sirrdh
of the first §tage of Epilepsy before the profound stupor sets in.
6. Cry.
Hahnemann has, among the symptoms he collected from
Greding, recorded the foUoMdng, 1322 : — "With a sudden cry
he trembles in the hands and feet"
The fall, the asphyxia, and the violent general convulsions,
are by no means peculiar to Belladonna. All narcotics which
have the power of producing a state of true coma, do so by
causing in some way or other venous, instead of arterial, blood
to circulate in the brain. After a certain point the symptoms
are not those of the drug, but those of venous intoxication ;
and we must be on our guard not to argue from the appearance
of post'Coma convulsions, among the eflfects of any drug, that
it therefore possesses, any true spasms-causing power. The ex-
periments of Sir Astley Cooper abundantly prove that the inter-
ruption of the flow of arterial blood to the brain is quite
sufficient to induce violent epileptic-form paroxysms. But the
condition of the animal so treated is entirely different from
those in a truly epileptic condition — such as Dr. Brown-S^quard
induces by injuries of the central parts of the nervous system.
This is not so with Belladonna, for the more we investigate
the effects of this drug, the more am I convinced we shall find
in it the symptoms bearing a close resemblance with all the
essential ones of Epilepsy ; and if we pass from the observed
phenomena to their probable causes, I believe that the reason
why Belladonna produces the image of the natural disease is
because it has the power both to induce in the central parts of
the nervous system a morbid congestion ; and, also, to excite in
the peripheral nerves a morbid supersensitiveness to impres-
mosiB ; 80 that while on the one hand it predisposes to con-
Yiilsi<»is by accumulating blood in the spinal cord, medulla
VOL. hl 18
274 Lecture hy Dr. Russell on Epilepsy.
oblongata, and brain ; on the other hand, it facilitates the
operation of the exciting causes of those convulsions by render-
ing the surfaces of the body (both the external — the skin, and
the internal — the mucous membranes), more liable to be offended
by every irritant.
The expectations raised by a study of the symptoms pro-
duced by this wonderful drug, when given as a poison, or to
ascertain its action in the heathy person, have been fully
realized by the effects observed of its administration in the
treatment of epilepsy.
The curative ef&cacy of Belladonna in epilepsy is attested
by so many trustworthy observers, that my surprise is that it
has not won a more general acceptance by thr medical profes-
sion at large. My own experience in favour of Belladonna is
that it actually cures this disease even when it presents itself
in its most formidable character. I may give one or two
cases in illustration of the grounds of my confidence in this
medicine.
A. G. — Oct. 17. — ^A well-grown and intelligent lad became
subject to epilepsy three years ago. After the first fit there
was an intermission for two months, then he had two fits ;
after that they recurred at intervals of every two, three, or
four months. He consulted me on the 24th of August, 1855,
he had six fits on the previous day, and one that morning.
The fits begin with convulsions of the muscles of the face,
which extend to the arms and legs. He is generally uncon-
scious for twenty minutes. He was ordered two drops of the
second dilution of Belladonna three times a day. He took this
medicine tUl the 1 1th of January, when he had one fit during
the night. The medicine was continued till the 14th of July,
and there was no return of a fit. I believe he has kept quite
free of them ever since. He certainly was so for some years.
The fits were of the true epileptic character, and in some
respects bad ; for there was very deep coma, and the length of
a paroxysm was rather above the average period. He took the
Lecture by Dr. RvMell on Epilepsy, 275
medicine for eleven months; and, as the fits came on about
the age of puberty, and were increasing in severity and numbers
for three years, the chances of this favourable termination being
spontaneous are certainly not so great as that they were cured
by Belladonna.
Case II. — A fine intelligent boy of 14 years of age came
under my care upon the l7th of December, 1855. His
parents stated that he had been subject to convulsions as an
infant, and from that time he had suffered from strabismus.
His present malady has lasted for one year. He is affected
with an unpleasant sensation coming over head and hands
several times a day, and one or two regular epileptic fits every
day. His general health is good. On the 31st of December
he began to take the second dilution of Belladonna three times
a day, and continued to do so till the end of April During
the whole of these four months he remained perfectly free from
aU epileptic symptoms or paroxysms ; and, so far as I know,
he has been in perfect health ever since. The slight general
uneasiness this boy complained of is very characteristic of true
epilepsy, and I have no doubt this case was an example of that
disease, and that it was radically cured by Belladonna.
Case III.^A big lad, 19 years of age, of a very dull
expression of countenance, and an almost idiotic gait and de-
meanour, was brought to me on the 16th of March, 1856. He
had been suffering from epilepsy for six years. The fits oc-
curred two or three times a day, but not every day. He was
ordered to take a dose of the second dilution of Belladoima
three times a day. He returned on the 2nd of April, and his
mother reported that he had had two bad fits the last week.
The medicine was continued. He remained free of all attacks
till the 14th of May, on which day he had one fit. On the
23 rd of July he was brought to me again. His mother as-
sured me that there was a marked improvement in his general
intelligence, and that the fits were less frequent and less severe.
After this I lost sight of the case.
18*
276 Lecture hy Dr. Russell on Epilepsy,
Case IV. — A girl of 14 years of age, of healthy appearance,
was brought for my advice on the 20th of March, 1857. ronr
years ago, i. e., when she was ten years old, she had her first
epileptic fit. It occurred without any assignable cause, and
was very severe. The fits returned at irregular intervals until
a year ago, when they began to occur regularly every month.
They last for about fifteen minutes, and end in sleep. When
she applied to me she had been free for three weeks, and
reckoned on one being due on the following week. The second
dilution of Belladonna was prescribed, a dose to be taken three
times a day. There was no fit from the 20th of March till the
22 nd of June, and none between that and the 12th of No-
vember. Thus, instead of eight fits in eight months, she had
only two fits, and I believe she kept well from that time. As
I find no mention made in my notes of the appearance of the
catamenia, I presume that this change in the constitution had
not occurred during the treatment, and that the amendment
was due to the persistent use of Belladonna.
These four cases occurred when I was practising in Leaming-
ton, and along with some other striking recoveries or improve-
ments in similar cases, were so much talked of that I was con-
sulted by a great many epileptic patients, and have ever since
had a number of such cases under my care. I must make
the mortifying confession that although even in apparently
very bad cases I have been able to effect great improvement,
yet that in very many I have foimd myself entirely baffled;
and the tantalising feature of the affair is, that I find I cannot
pronounce with any confidence as to the probability of the issue
in any given case. I know of no special indications for the
use of Belladonna, nor do I know beforehand whether a case
will get better or worse, or remain stationary. I have been
disappointed in cases which looked the most promising, and again
other cases which presented all the worst appearances have
been the most benefitted.
The next medicine to which I wish to direct your attention,
is Hydrocyanic acid.
Lecture hy Dr, Russell on Epilepsy. 277
Tn the number of the British Journal of Homeopathy for
July, 1862, there is an elaborate article by Dr. Madden and
Dr. Hughes upon the action of Hydrocyanic acid, and especially
upon its relation to epilepsy. At the end of the article there is
the following note : — " In the next number of the journal we
propose to give a series of cases of epilepsy and other diseases
treated by this drug. If any of our colleagues have had ex-
• perience with it, or should be led to use it successfully in the
direction indicated in the above paper, we should be greatly
obliged if they would communicate to us their observations,
that we may incorporate them in our series." Having been for
long much interested in the subject of epilepsy, I have opened
each of the successive numbers of the journal with great curi-
osity to read the cases which are here referred to as having
been treated before July, 1862, with this drug. Up to this
time, however, they remain unpublished, and in the absence of
all a posteriori evidence in favour of the power of Hydrocyanic
Acid to cure epilepsy, we must examine even more critically the
preofe advanced in the paper just referred to.
Having already confessed how often I have been baffled in
all my attempts to effect a cure of epilepsy, I need hardly say
that I began the perusal of the article with a lively hope of
finding the authors of it to be right in their belief that Hydro-
cyanic Acid deserved a place next to Belladonna in the treat-
ment of this dreadful malady. This hope seemed to me the
more legitimate inasmuch as we had from the same joint-pen
received so valuable an article upon the relation of Belladonna
to this disease — an article which showed that its authors had
carefully arranged in their preper order, and valued at their
just proportion, the symptoms which characterise epilepsy.
However, I must at once confess that the more I studied the
article the less I was satisfied with the conclusions arrived at
in it, I wiU state my opinions rather in the form of questions
than of opposing prepositions.
. The first I would note is whether there is any evidence of
278 Lecture by Dr, Russell on Epilepsy,
Hydrocyanic Acid producing a permanent impression upon the
nervous system ? To me it seems to act as a very intense and
very evanescent direct sedative. Let us take, for example, a
case recorded in the "Eevue Medicale," and quoted by Chris-
tison and Hempel, as well as by the authors of the article under
consideration. It is quite a model case, and the substance of
it is thus given by Drs. Hughes and Madden : —
" Very soon after swallowing a teaspoonful of the diluted •
acid, he felt a confusion in his head, and then fell down in-
sensible as suddenly as if struck by lightning." Let us pause
to observe that up to this point there had been no convulsions,
nor any symptoms beaiing any resemblance to epilepsy. And
this is the rule, not the exception. Thus a case is related in
" Hufeland's Journal," and quoted by Wibmer and Christison,
of a man who took a large dose of this poison, and " after stag-
gering a few steps he sank without a groan (and without a
struggle) to the ground. A physician who saw him on the
instant found the pulse gone and the breathing for some time
imperceptible." To return to the former case, the narrative
proceeds : — " There was difficult breathing ; small pulse, scarcely
perceptible at the left wrist ; bloating of the face and neck ;
dilated and insensible pupils; and lock-jaw. Afterwards he
had several fits of tetanus, one of them extremely violent. In
about two hours and a-half he began to recover his intellect,
and rapidly became sensible." On this we have the following
comment : — " The epileptiform loss of consciousness, the tetanic
convulsions, and the spasmodic dyspnoea of Hydrocyanic Acid,
are well marked in this case." I confess I cannot see the re-
semblance to epilepsy. It seems to me much more like a
transient attack of apoplexy ; for let us observe that the con-
vulsions did not occur at all till after the bloating of the face
and the insensibility of the pupils demonstrated that narcosis,
or poisoning of the brain by venous blood, had taken place. It
was a toxical repetition of Sir A. Cooper's experiments. The
supply of arterial blood was suddenly cut off from the brain
Lecture hy Dr, Russell on Epilqpsy. 279
medulla oblongata, and spinal chord, and the consequences of
this were insensibility and convulsions. And so little had the
poison affected the nervous centres in a strictly morbific
manner, that very soon he began to recover, and so far as we
know was no more affected by this powerful drug than if he
had been strangled and restored to life. In fact the symptoms
are those of strangulation, and as such they bear a close resem-
blance to the effects of an epileptic seizure, which indeed
strangles its victim as effectually as if a bow string were
tightened round his throat. But again I say I see no proof
of Hydrocyanic Acid acting directly on that part of the nervous
system which is the seat of epilepsy. We miss entirely the
early dilatation of the pupil before the establishment of uncon-
sciousness, which is one of the pathognomonic symptoms of the
malady.
Is there any evidence of Hydrocyanic acid exerting a long-
continued morbific influence ? Are not its effects like those
of camphor — ^very powerful, but very evanescent ?
Have we sufficient evidence of its action when given much
diluted ? I mean, as we are in the habit of prescribing our
medicines. Will the millionth of a drop produce any effect ?
We know that a pure stimulant is annihilated by dilution, as
in the instance of Alcohol. May it not be the same with a pure
sedative ? These are very important questions to have answered
before we place our confidence in this remedy, and questions
which I trust we shall have answered, as well as the produc-
tion of the promised cases exhibiting the curative efficacy of
Hydrocyanic Acid in epilepsy.
Ouprum, either in the form of the triturated metal, or of the
acetate of copper, is in high favour in the Homoeopathic treat-
ment of epilepsy; and certaruly it seems to fulfil the conditions
we require of an anti-epileptic medicine ; for its effects are both
peripheral and central, and of long endurance. For example,
Wibmer relates the case of a girl of eighteen years of age who
was poisoned with a salt of copper, and in whom it produced
280 Lecture by Dr. RiisseU an Epilepsy.
convulsions, and then insensibility. Some days afterwards a
certain amount of paralytic weakness of the arms remained^
general disturbance of the whole system followed, and even-
tually she died. After detailing a number of cases of poisoning
by the acetate of copper Wibmer concludes with the following
summary : —
"Various observations make it probable that copper acts
upon the brain, and even more upon the spinal chord. We
meet with headache, often irrational talk, slight deafness, but
more frequently twitches, trismus, and almost tetanic stiffness
of the limbs, as consequences of poisoning by this metaL"
In the proving of Cuprum given to us by Hahnemann
we find numerous symptoms and groups of symptoms bearing
a close resemblance to those of a paroxysm of epilepsy. Ifoack
and Trinks observe that Cuprum " is especially suitable for
relaxed, irritable, and nervous constitutions, with weakness and
excessive sensitiveness of the nervous system."
So far as my own observations go, I must admit that I have
been disappointed in this remedy in the treatment of epUepsy,
and I am inclined to think that the action of copper ia rather
upon the ramifications of the nerves than upon their central
origin. It is of great use in certain forms of spasms arising
from which might be caUed circumscribed reflex-action, as in
some kinds of colic, and choleraic spasms. It is likewise of
great use in certain forms of oppression of the brain ; but it
does not seem to act so specifically on the upper part of the
spinal chord or medulla oblongata ; it does not, like Belladonna^
dilate the pupils. In short, although presenting many striking
features of resemblance in its effects to the symptoms of
epilepsy, it does not seem to hit the exact likeness, and is per-
haps more suitable for various kinds of epileptiform convulsions,
and for general choraic tremors than for true epilepsy.
I have certainly seen decided benefit from Arsemcum — a
medicine not nearly so much in vogue among Homoeopathists
for the cure of epilepsy. That Arsenicum does, however, some-
Lectv/re hy Dr. Russell on Epilepsy, 281
times produce a set of symptoms closely resembling those of
epilepsy is undoubted, and well illustrated in the following
case: —
" A girl swallowed a drachm of arsenic, and was in conse-
quence attacked violently with the usual symptoms of irritation
in the whole alimentary canaL After a succession of ordinary
symptoms, a new train gradually appeared. Towards the close
of the second day she was harrassed with frightful dreams,
starting from sleep, and a tendency to faint ; with coldness
along the spine, giddiness, and intolerance of light ; and, on the
fourth day, with aching of the extremities and tingling of the
whole skin. This symptom continued till the close of the
sixth day, when she was suddenly seized with convulsions of
the left side, foaming at the mouth, and total insensibility.
The convulsions lasted two hours, the insensibility through the
whole night iText evening she had another and similar fit ;
a third, but slighter, occurred on the morning of the tenth;
another next day at noon ; and they continued to occur occa-
sionally till the nineteenth day.*'
The gradual formation of the epileptic condition is curiously
exhibited here. Over sensitiveness of the periphereal nerves,
so that there was more than the proper amount of stimulus
borne inwards to the centre, while, at the same time, an ab-
normal state of the upper part of the spinal chord was engen-
dered, in consequence of which there was preternatural tendency
on its part to be excited. Here we had the train laid by one
hand, and the match applied by the other.
It is further to be observed, in regard to Arsenicum, that it
produces intermittent fever ; and Dr. Brown-S^quard has pointed
out that the ague, and epileptic conditions of the body are reci-
procally antagonistic. For these reasons, as well as on the
grounds of having seen it do good, I am disposed to press this
medicine on your attention in cases of epilepsy.
Another medicine, which has seemed to me of unequivocal
benefit, is Jjfajay and we should expect it to be so from the
282 Lecture by Dr. Russell on Epilepsy,
effects it produces when it enters the system in such a way as
to exert, to its full extent, its morbific influence. In the
reports of fatal cases from the bite of the cobra di capello we
have the most characteristic symptoms of epilepsy occurring in
the proper order of succession. First, there are convulsive
twitches of various muscles, showing a general agitation of the
peripheral nerves ; then come insensibility and violent convul-
sions, with foaming at the mouth. Dilatation of the pupil is
also sometimes observed at an early stage. Thus from Lachesis
and Naja we have every reason to expect good results in the
treatment of epilepsy; and, so far as my experience goes, it
confirms these expectations.
From Nitrate of Silver I have never succeeded in obtaining
any satisfactory results. This may be owing to its popular use
and even abuse ; for, as it rarely happens to us to be called
on to treat a case of epilepsy which has not been previously
under any course of medical treatment, in the majority of our
cases this remedy has been given, and failed to do good. Dr.
Gray, of !N'ew York, than whom we have no more trustworthy
observer, tells us that "Epileptic attacks produced by moral
causes, e.g., impassioned lay preaching, are promptly and directly
cured by a few small doses of this medicine."
Nux Vomica is certainly a most useful medicine in the treat-
ment of epilepsy ; but rather, as it appears to me, by removing
the peripheral exciting causes, than by acting on the abnormal
condition of the nervous centres. However, as I have seen
undoubted benefit from its action in some obstinate and severe
cases, we should not deprive ourselves of its use by any specu-
lative objections as to its inability to produce the cerebral op-
pression which characterizes epilepsy.
The same observations hold good of Pulsatilla.
In thus winnowing out of Dr. Laurie's fifty medicines these
five or six, I by no means wish to cast a slight upon the others;
but, as these are clenical lectures, I have confined myself
exclusively, or nearly so, to giving expression to the result of
Cases by Mr. Yeldham. 283
my own personal experience and observation. I only regret
that it is not more satisfactory ; and I trust that, by and bye,
we shall have, instead of vaguQ indications and general direc-
tions for the use of remedies in epilepsy, a collection of well-
attested cures of this terrible affliction, so that we may discover,
with some approach to accuracy, what are the peculiar indica-
tions on which we may rely for giving a preference to one
remedy rather than to another, in selecting that which is the
most appropriate to every particular case of the disease, to-
wards the cure or mitigation of which our remedial efforts are
directed.
CASES TEEATED WITH HIGH DILUTIONS, BY MR.
YELDHAM, M.RC.S., Surgeon to the Hospital.
Case VTI. — ^Frederick Goodman, aged 16 : admitted No-
vember 12, 1863 : discharged December 2nd. Result, cured.
Oastric irritation with headache. — A fortnight ago was seized
with pain in the head and loins, with tendency to fever. The
pain in the head has continued ever since.
Nov. 13th. — He now complains of dull heavy pain in the front
of the head — ^heis evidently much oppressed by it — ^it causes him
to stoop, and to move with great caution, and to avoid the light.
He has neither appetite nor thirst ; tongue dry, and red in the
centre : white and moist over the rest of its surface, except the
edges which are clean. Pulse 84 ; skin hot and moist; bowels
inclined to be relaxed ; urine high coloured.
Aconite tinct. 200, a drop three times a day.
Nov. 19 th. — StUl pain in the forehead, at times ; feels weak ;
tongue slightly coated.
Nux Vomica 200, three times a day.
Nov. 23rd. — Head better, though there is still dull pain in
the forehead. Has pain in the abdomen, after food, as if
from flatulence.
Saccharum Lactis.
284 C(wes hy Mr. Yeldham.
Nov. 25th. — Head worse yesterday and to-day: astupifying,
dull, heavy pain ; stomach uncomfortable after food.
Nux Vomica, first decimal, a drop three times a day.
Nov. 30th. — Very much better; very slight pain in the fore-
head ; has slight pain across the epigastrium.
Continue the Nux Vom., first decimal
Dec. 2nd. — -Feels quite well. Discharged, cured.
Case VIII. — ^Ellen Mills, aged 37; single; servant — admit-
ted November 27th ; discharged, December 21st. Eesult, cured.
Gastrosis. — ^Three weeks ago felt a pain in the bowels after
dinner, which has continued up to this time. Now complains
of constant violent pain, principally in the epigastric region,
shooting through to the back ; worse after food, and increased
by pressure. When first seized had sickness and vomiting after
every meal, but these symptoms have abated within the last
week. There is no appetite ; thirst, and bad taste in the mouth ;
bowels act regularly; has headache; skin cool.
Take Aconite 200, a drop three times a day.
Nov. 30th. — Much the same.
Take Belladonna 200, a drop every four hours.
Dec. 4th. — Continues the same.
Take Belladonna, first decimal, 3 drops every four hours.
Dec. 7th. — Considerably better ; pain stUl felt, though in a
very mitigated degree.
Continue same medicine.
Dec. 9th. — More pain across the colon since yesterday
afternoon, with some frontal headache.
Saccharum Lactis.
Dec. 12th. — Very considerably better; pain greatly dimi-
nished, both after food and at other times.
Dec. 14th. — Still better, even when sitting up, which
hitherto has much increased the pain — felt only when lying
on the left side.
Saccharum Lactis.
Cases hy Mr, Yeldham, 285
Dec. 16th. — ^Much same as at last visit, still some discomfort
after food.
Cocculus 200, a drop three times a day.
Dec. 19th. — Better; sat up yesterday with greater ease than
before.
Dec. 21st. — Pain scarcely felt at all; feels sufficiently well
to go home. Discharged.
Case IX. — James Rayman, aged 30 ; a labourer — admitted
November 12, 1863; discharged, December 14. Result, cured.
Ague, — A stout, muscular man. About three weeks since
got wet and caught cold ; he coughed for a week and then had
a shivering fit ; this recurred every second night until four days
ago, since when he has had the shivering every night. In Oc-
tober, was working three weeks in the Wolds of Yorkshire,
where ague prevails. On admission, states that for the last
four days the shivering has come on about three or four o'clock
each morning, has lasted for an hour, and has been followed by
hot stage, which lasts about half an hour, and is succeeded by a
gentle perspiration. He is always thirsty, but more so during
the hot stage. Pulse, at eleven a.m., 90. Skin cool; tongue
coated white ; urine high coloured, and thick ; bowels regular ;
has slight cough at night.
Take Arsenicum 200, a drop every four houra.
Nov. 1 9 th. — Shiveringshave recurred much the same as usual,
perhaps a little slighter last night ; less heat and sweating ; ex-
ceedingly thirsty in the night ; pulse 112, weak, ansemic looking
and feels exceedingly prostrated ; tongue broad, red, and glazed.
Arsenicum 3rd decimal, a drop every four hours.
Nov. 21st. — Had shivering on the 20th. Last night had
copious sweating between twelve and one o'clock, but no
shivering; slight thirst.
Nov. 23rd. — ^At noon, on 21st, had a shivering fit which lasted
an hour and a half. Fever followed, but no sweat. Has had no
shivering since, but feels giddy, and has a mist before his eyes,
at times.
Continue same medicine.
286 Cases hy Mr. Yeldham.
Nov. 25th. — For last two nights the shivering has been as
before, has come on at the usual time, and has been succeeded
by fever and sweating.
Chinium Sulphuricum, ^ 5 drops every four liours.
Nov. 30th. — Continues much the same.
Chinium Sulphuricum ^ grain every two hours.
Dec. 2nd. — Shiverings the last two days have come on at six
in the morning.
Chinium Sulphuricum ^ grain every two hours.
Dec. 4th. — Yesterday shivering came on at noon. Feels
better to-day.
Continue same medicine.
Dec. 7th. — No shivering the last two days.
Dec. 9 th. — Has had no shivering. Improves rapidly.
Eepeat the same medicine every four hours.
Dec. 12 th. — No shivering. Well, except a little uneasiness
in the loins.
Dec. 14th. — No recurrence of the shiverings. Feels quite
well, and is discharged.
CsEA 10. — Jane Amos, aged 21; married; admitted Oct*
20th, 1863 ; discharged Nov. 18th. Result, relieved. Disease,
Rheumatism.
When six years old, and again when ten, had Rheumatic
fever. Since last attack has enjoyed good health till a fomight
ago, when she felt pains in head, shoulders, and arms. These
pains have continued, more or less, since. On admission com-
plains of pain on motion in back of neck and shoulders. Her
tongue is clean at edges and in centre, but has two stripes of
fur ; appetite fair ; bowels regular ; catamenia ditto ; Pulse 110 ;
skin cool ; sleeps badly ; heart sounds, normal
Oct. 23. Aconite 200, three times a day.
Oct. 25th. Worse. Pain has extended to^the other shoulder.
Bryonia 200, a drop every four honrs.
Oct. 28 th. Better in herself. Left shoulder painful, like knives
Cases by Mr. Yeldham, 287
pricking her, and preventing sleep. Not so thirsty. Tongue
deeming.
Continue Bryonia, 200.
Oct. 30th. Less pain in shoulder, can move it better.
Nov. 2nd. Flying pains in different parts of body, though
generally better.
Pulsatilla 200, a drop every four hours.
Nov. 5th. Feverish all night and no sleep. Catching pain in
right side of chest on moving and breathing, and in the region
of the heart, the sounds of which are healthy. Pulse 120. She
has had meat diet hitherto, and is now to omit it.
Take Aconite 2j00, a drop every four hours.
Nov. 6th. The catching pain in right side continues.
Bryonia 200, every four hoois.
Nov. 9th. Had a good deal of pain last night. This morning
it is felt ia one foot. Feverish.
Aconite 200, every four hours.
Nov. 11th. Has pain in the right arm, and in the face and
teeth ; aching, shooting pains which are worse when the teeth
are closed.
Merc. cor. 200, every four hours.
Nov. 16th. Varioloid looking spots appeared on the body two
days ago, these are now dying off. She does not progress
with respect to the rheumatism. Has pains in different parts
— the right wrist is swollen and painful, fixedly so for three
days; tongue coated white, pulse quick — 120 — and weak.
Bryonia 3rd dec. ; three drops every four hours.
Nov. 18th. General health better — still has flying pains. She
wishes to leave the hospital, and is to have Bryonia Pilules of
the 3rd to take three times a day. Further result not known.
Case 11. James Hubert; age 31 — a shopkeeper. Admitted
Dec. 3, 1863. Discharged Dec. 23. — Eesult, cured. Disease.
Bronchitis. — Has been subject to attacks of breathlessness
288 Cases by Mr. Yeldham.
for ten years, which seem to be brought on by cold. Has had
such an attack the last two months. He is breathless, espe-
cially at night, with a hard cough, and tough greenish expec-
toration. Has slight pain when he draws a long breath.
Sibilant rales are heard all over the chest. Pulse 96, small;
skin cooL Bowels regular; tongue coated. Feels sick and
thirsty.
Tine. Nux Vomica 200, three times a day.
Dec. 9 th. Is easier ; cough looser. Has had a good night.
Continue medicine.
Dec. 12th. Breathing was worse last night. Cough dry, and
expectoration less easily raised.
Tine. Ipecacuanha 200 ; three times a day.
Dec. 16th. No better.
Take Tine. Ipecacuanha, 1st dec. 3 drops every four hours.
Dec. 19th. "Feels decidedly better since beginning the last
medicine." Less wheezing, cough easier.
Continue.
Dec. 21st. Much better ; but still coughs of a morning.
Nux Vomica 200, for three days.
Dec. 23rd. A little cough stiU.
Discharged.
g^nnals of i^t S^amt^a.
OBSEEVATIONS ON THE PHYSIOLOGICAL AND
THEEAPEUTIC EFFECTS OF ALCOHOL.
By Alfred C. Pope,
Mb. President and Gentlemen, — ^The daily consumption
throughout the world of alcoholic fluids, the deep interest these
beverages possess for us, as the origin of some forms of disease,
and the source of the intractable nature of many others, and
their admitted value as remedial agents, constitute, for the care-
ful and impartial investigation of their physiological and thera-
peutic effects, claims, the strength of which no one, I presume,
wiU feel disposed to question ; the subject is one to which, as
guardians of the public health, we are bound to accord a patient
and attentive consideration. In introducing it to you to-night,
I purpose laying before you a study of the modus operandi of
alcohol in health, and therefrom shall endeavour to deduce its
sphere of action in the treatment of disease.
In attempting to fulfil this intention, I propose to consider.
First, the symptoms following the use of alcohol in a healthy
man while fasting and unemployed, the results of experiments
upon the lower animals instituted with the view of determining
its characteristic effects, and the modes of death, with the
morbid appearances ensuing its use in poisonous quantities.
Secondly, I shall examine, by the light these facts afford, the.
principal theories propounded to explain its action. And,
Thirdly, from the same source I shall infer the nature of those
morbid conditions, in the treatment of which we shall find
alcohol to prove the most serviceable medicine we can employ.
By no method can we obtain so clear an insight to the
VOL. HL 19
2yo Obscrvatiuits un the Physloloyical and
actions and uses of any substance as by that which, if not first
])ioj)»)s«m1 by irabneinann, was by him unquestionably first put
to any ])ractical use, and subsequently so developed as to pro-
vide us ^vith a Materia Medica, not only extensive, but easily
understood and readily available. Chemistry, botany, or the
empirical use of a presumed remedy in a variety of diseases can
never provide us with information so reliable as that derivable
from experiments with it on the healthy body. Amongst those
of our l^rofession who do not as yet recognize the value of the
llomu'opatliic law as a therapeutic indicator, this method of re-
search n^garding the properties of new remedies, and of some
old ones, is becoming more frequent. We may well congratu-
late ourselves that it is so, seeing that if persevered in, it must
l(»ad them — as seventy years ago it led Hahnemann — to see in
the law of similia similihiis curantur the true guide to the
select ion of remedies.
After this manner alcohol has been studied by Dr. Edward
Smith, of the Brompton Hospital, and to a very slight extent
by Dr. ('hauibers, of St. Mary's. The latter gentleman has yet
much to learn in the matter of drug proving ; for when detailing
some of the results of taking daily an addition of a moderate
quantity of alcohol to the usual meals, he says, — " On the next
day, the a])petite for food was observed to be somewhat less
than usual, and tlie experiment ceased ; for any alteration of
usual weight, health, feeling, or habits, of course would vitiate
the r(\sult of an investigation conducted in this form." On the
contrary, it is a knowledge of the changes in health, weight,
and feeling arising from the ingestion of a given substance, that
w^e desiderate ; to obtain it, such experiments are alone under-
takcjn.
I)r. Smith, however, w^as less chary of his health and feelings,
and lias, with the assistance of a friend, furnished the Profession
with a very valuable proving of alcohol. The symptons re-
sulting iVom taking a moderate quantity of duly diluted alco-
hol, of brandy, of gin, rum, whiskey, ale, and porter on an
Therapeutic Effects of A Icohol 291
empty stomach, early in the morning, aiv ji" on by him in the
natnral order of their succession, the duration of their action,
and with their attendant circumstances. They are recorded in
the first volume of the Lancet for 1861.
From this proving we learn that the circulation was the
function first impressed; and, almost immediately, the brain
became excited ; shortly afterwards, the spinal cord, the respira-
tion, and, lastly, the sympathetic system, gave evidence of being
influenced by the alcohol. " In three minutes after taking the
spirits and water, the action of the heart was increased, and
continued so for from thirty to forty minutes. This was at-
tended by a sense of dryness, heat, and evident fulness of the
exposed parts of the skin, as the hands and feet, and also a
general sensation of heat. The skin was as harsh and dry as
when exposed to an easterly wind. After about twenty to
forty minutes, tliis sensation of heat gave place to one of cold,
first felt in the most sensitive parts of the body in reference to
temperature — ^viz., between the shoulders, and at length, not-
withstanding the existence of a suitable atmosphere, became
distressing, and led even to shivering. This was sometimes 50
marked and occurred so suddenly, that it gave rise to a shock.
It did not correspond with the temperature of the skin, but it
was usually co-existent with the cessation of increase of the
heart's action."
In these details we have the action of alcohol on the circu-
lation, and some of the consequences thereof well delineated.
The heart is at first stimulated to increased activity. The blood
circtdates in gieater volume, and with more rapidity, carrjang
with it increased heat to the surface and extremities. As its
primary influence passes off, the central organ of the circulation
works less vigorously, abnormal contraction of the capillaries
follows their previously abnormal dilatation, and the recently-
acquired warmth of the body gives place to a sensation of cold
so considerable as to amount to " shock."
The first indication of the cerebral organization being influ-
19^
292 Observations on the Physiological and
enced by the alcohol, was felt by Dr. Smith almost coin-
cideiitly with increased cardiac action, and to the state of the
circulation it was probably due. "A sensation of fulness at
the crown and back part of the head, or at the temples, accord-
ing to the kind of spirit taken," was the first symptom of nervous
disorder noticed. In from three to seven minutes the mind
b3came disturbed. In the words of Dr. Smith, — " consciousness,
the power of fixing the attention, the perception of light, and, we
believe, of sound also were lessened ; the power of directing and
co-ordinating the muscles was also lessened, whilst there was
a very marked continuous purring or thrilling, and not un-
pleasant sensation passing from above downwards through the
whole system. Tliis latter symptom was most pronounced in
from fifteen to forty minutes, and continued without much
variation during twenty to thirty minutes. After this period
the whole effect recorded under this head diminished, and
oftentimes suddenly, as was shown by an increased perception
of light, as if a veil had fallen from the eyes, and by increased
consciousness ; but, nevertheless, the last power to be completely
regained was consciousness."
Again, the effect of alcohol is manifested in the mental con-
dition induced. " Eum and some other spirits," says Dr. Smith,
" made us very hilarious, so much so that my friend was alto-
gether a king ; but as minutes flew away, so did our joyousness,
and little by little we lessened our garrulity, and felt less happy,
until at length, having gone down by degrees, we became silent,
almost morose, and extremely miserable."
Through the medium of the nervous system, again, the
muscular apparatus of the body becomes disordered. "The
thin layers of the voluntary muscles found about the body
showed great relaxation. The respiratory muscles acted in a
gasping manner, so that there was a pumping and quick inspi-
ratory effort in the earlier, and a feeble expiratory effort in the
later stage. At aU periods there was a sense of impediment to
respiration." Though I cite these symptoms here as evidence
Therapeutic Effects of Alcohol 293
of the lack of nervous force induced by alcohol, they are but
partly due to this cause, being probably the more direct result
of that vitiated, that imperfectly aerated state of the blood to
which alcohol gives rise. To continue, — " The muscles of the
limbs were inactive. There was relaxation of the muscles and
stiffness of the skin of the face, forehead, and upper lip, so that
the features fell. The state of the muscular system followed the
commencement of the effect upon the consciousness, and other
functions of the brain, and also the excited state of the heart.
In reference to its cessation, the power of co-ordinating the
muscles was the first regained, whilst the buzzing sensation
and semi-cataleptic state continued, and the disposition to use
the muscles was regained the last of alL"
In the earlier of the symptoms I have detailed, we find a
diminution in the nervous power of the senses; a partial paraly-
sis, as it were, of sight and hearing, accompanied by a general
excitability of the whole nervous system, as remarked in the
continuous purring and thrilling passing from above downwards.
We subsequently saw a perversion of nervous energy in the
mental phenomena evoked. The brain, the medium of the
mind, was disordered, and evinced its morbid state primarily in
excitement, and secondarily, in depression. The former de-
pending on the increased activity of the circulation throughout
its substance ; the latter arising from the specific action of the
alcohol upon it, from the depraved condition of the blood. The
spinal cord, though less powerfully and less permanently affected
by the alcoholic fluid, is, nevertheless, very strikingly influenced
by it, as seen in the impaired power, if not altogether of
moving, at any rate of co-ordinating the action of the muscles.
In these experiments of Dr. Smith and his friend, we find
ample evidence of the sphere in which alcohol exhibits its
peculiar influence. .Physiological and pathological investiga-
tions point to a similar direction. To some of these researches
I will refer.
Dr. Marcet, in the course of a series of experiments detailed
2'.»4 Observations on the Physiological ami
but'oro the Hritish Association at its meeting at Aberdeen in
185'.» (Mailed I Time^ and Gazette, March, 1860), showed that
fro<^rs into whom he had injected alcohol died more rapidly from
])()isnn(nis shock, when both the circulation and nervous com-
nuiiiieations were free than when any mutilation of nervous
trunks liad been previously practised. Thus demonstrating
that the nerves themselves are conductors of the alcholic
])()ison; that the nervous system is influenced in all its parts,
in its tmcts as well as in its centres. From an ingenious
comparison between the observed action of alcohol and an
experiment of M. Claude Bernard's, Dr. Marcet infers the
nature of the influence of alcohol on the sympathetic system.
He remarks, at page 13 of his work on "Alcoholic Intoxication,"
" wlien fermented beverages are taken in moderate quantity, it
is obvious from the increased rapidity of the circulation they
induce in the membranes with which they come in contact,
that the alcoliolic fluid exerts a local action on the nerves
ramifying in those membranes. It is difficult to determine the
precise seat of this action, but we may surmise that it is
exerted principally on the sympathetic, this system supplying
twigs which accompany arteries into their minutest divisions.
If we now bear in mind the facts revealed to us by Claude
Bernard, that by cutting a branch of the sympathetic nerve, the
circulation of the part which is supplied by that nerve is
greatly increased, and also that this very same increased rate of
the circulation takes place where alcohol is present in the
stomach, it is but rational to conclude that alcohol, when first
absorbed by the minutest blood-vessels, has the property of
lessening the normal functions of the sympathetic nerves which
supply those vessels." The same observer has, in the series of
experiments already alluded to, shown that the shock which has
been known to follow the sudden imbibition of large quantities
of raw spirits, is due to their direct action on the extremities
of the cerebro-spinal nerves. Thus in a frog, in which the
circulation had been arrested, temporary insensibility was
Therapeutic Effects of A Icohol. 295
induced when the hind limbs were immersed in alcohol, while
in one where the circulation was undisturbed, but the nerves of
the limbs placed in alcohol severed fi*om their centre, no shock
occurred. Thus demonstrating that in sudden shock the
impression is conveyed to the centre solely by the nerves and
independently of the blood vessels.
Again, there are certain excretions dependent partly on
changes in the nervous system, such as the phosphatic salts,
which are altered under the influence of alcohol. Dr. Chambers
alleges that they are diminished ; but, as he never carried his
investigations beyond the primary stage of alcoholism, and as
there are many observations tending to rebut his conclusion, the
probability is, that when the deeper action of the spirit comes
into play, these are largely increased. Some observers have
remarked a diminution in the amount of ui^ea excreted under
the influence of alcohol ; others have stated that it is in excess.
In all likelihood this excretion is not changed in quantity, for
Dr. Brinton has shown that when diminished in the urine its
place has appeared to be supplied by the large increase which
takes place in the ammoniacal constituent of the foeces. The
channel of excretion, and not the excretion itself, it is that is
altered.
While pathogenetic and physiological experiments show the
power of alcohol over the nervous system, pathological investi-
gations tend to the same result.
Dr. Ogston, of Aberdeen, in 1833 detected alcohol in the
ventricles of the brain of a person who had died in a state of
intoxication. Dr. Percy was led by a similar observation to a
more extended series of experiments, the thesis in which they
were published obtaining an Edinburgh University gold medal.
He procured alcohol from the brains of intoxicants by distilla-
tion. And, though he detected it by the same means in the
liver and the kidney, it was in the brain that he found the
largest proportion.
The mode of death from alcohol points to the nervous
296 Observations on the Physiological and
system as that upon which its lethal influence has been chiefly
exerted.
Death, as I have already noticed, sometimes occurs suddenly
from nervous shock, after the ingestion of a large quantity of
spirit. In a dog into whose stomach Dr. Percy injected two
ounces and a-half of alcohol death was instantaneous. But, speedy
as was the fatal result in its occurrence, alcohol was found in the
brain in a quantity equal to that which on previous occasions
had been yielded when the alcohol had had much longer time
to accumulate.
In cases where death supervenes more gradually, the
symptoms are traceable not merely to nervous derangement, but
also to deficient aeration of the blood. Coma, convulsions,
apoplexy, and asphyxia constitute the more prominent features
in persons dying of alcoholic poisoning. An interesting and
instructive case of this nature, illustrating alike the rapid
absorption of alcohol, and the direction of its action is recorded
by the late Dr. Todd in his "Clinical Lectures on Acute
Diseases " (p. 44, 1st ed.) A child, three years old, was brought
into King's College Hospital in a comatose state, having, about
six hours previously, had about a half-a-quartem (two-and-a-half
ounces) of gin administered to it. Coma supervened soon after
the gin was taken ; and when admitted she was still insensible,
though the pulse was good, the body and extremities warm,
and the eyes presenting a natural appearance. Emetics — the
cold douche to the head, a mustard and water bath, slapping
the feet and posteriors, were tried with the view of arousing
her, but produced no effect beyond crying and kicking, hit with
the right leg only. The left arm and leg were paralysed. Three
hours after admission an epileptic fit occurred, with convulsive
twitchings of the left side of the body and face. The right
side shared also in the convulsions, but only to a slight extent.
About twenty or thirty paroxysms of this character took place
during the night, the intervals being passed in a comatose
state. In three more days the patient sank exhausted, the
Therapmtic Effects of Alcohol 297
paralysis having continued unaltered, and on one occasion
only, on the day before her death, did she exhibit any sign of
consciousness. The brain presented an extreme degree of
pallor; but, beyond this, there was no abnormal anatomical
condition, either of its grey or white substance ; neither was
there any effusion into its cavities, nor any condition by which
coma could be accounted for by way of pressure. The only other
alteration observable, beyond the congestion of the lower lobes
of the lungs, was some degree of fatty degeneration of the
kidney. The result, in all probability. Dr. Todd remarks, of
previous mal-nutrition. In this case it will be seen that there
was no cerebral congestion, no structural lesion to explain the
severe nervous shock that brought life to a close. The power
of the brain to create nervous force was simply obliterated,
more completely so in one hemisphere than in the other. For
lack of the nervous energy supplied by the brain the patient
died.
While the paralysis and nervous irritation exemplified by
this and similar cases are due, in a very considerable degree, to
the elective affinity for alcohol possessed by the brain, the
morbid condition of the blood engendered by the excessive use
of spirits plays an important part in the production of the con-
ditions upon- which such disordered states depend. The rapid
absorption of alcohol by the blood noticed in Dr. Todd's case
has been remarked upon by all who have studied its action.
Dr. Percy in his experiments found the darkened arterial blood
of a dog to yield alcohol in distillation. But not only is it
thus absorbed, and so conveyed to the brain and other organs
upon which it exerts its most marked influence, but its pre-
sence alters the constitution of the blood. Dr. Boecker found
on comparing the blood of a person who never took alcohol in
any form with that of one who took daily a certain, but not
excessive, quantity of brandy, that in the latter the organic
constituents were deficient ; the proper amount of fibrine as
compaied with albumen was wanting ; the red clot was more
298 Observations on the Physiologhdl and
carbonized, or, at least, blacker than in health. The pale and
colourless corpuscles were, he observes, in excess. To this
source probably may be traced the dark colour of the clot
rather than to its admixture with carbon. The colourless
corpuscles are simply undeveloped red blood discs. They do
not become coloured on reacliing the hmgs, and hence the
blood itself, and consequently the clot formed from it, are dark
in colour. The experiments of Bourchardat and Sandras are
confirmed by those of Boiicker. They found the arterial blood
in a person under the influence of alcohol to have all the
characters of venous blood — to be evidently unoxidated. In
commenting upon the investigations of Boecker, Dr. Chambers
remarks " that the blood is less vitalized, is anemic, and at
the same time too venous, too much in the condition of the
portal system ; it retains too much of the efiPete matter, and is
deficient in new active globules" ("Digestion and its Derange-
ments," p. 231).
The observations I have here adduced afford no evidence, I
may remark in passing, of the decomposition of alcohol within
the circulation. On the contrary, it was obtained from it by
distillation by Dr. Percy ; while its dark, carbonized looking
condition, was due not to its having obtained an excess o
caj.'bon from an unusual source, but from that which it normallj
contained, deprived from efiPete matters, not having been elimi
nated. Dr. Smith's experiments on the influence of alcohol
on the respiratory process go to confirm the hypothesis. He
found, he tells us, that the respiration was " disturbed rathei
than materially altered " (" Philosophical Transactions, 1859")
The respiratory movements were, he says, in all instances, ex-
cept where porter was the alcoholic fluid used in experimenting
diminished in frequency. The carbonic acid excreted by th(
lungs was diminished when whiskey, brandy, gin, and sherrj
were taken. When pure alcohol was used, it was increased tc
nearly one-fifth of a grain per minute, the nonnal amount being
eight and four-fifths of a grain per minute. With rum, rum and
Therapeutic Effects of A Icohol. 299
milk, stout, and ale, it was more decidedly increased. The re-
sults probably of the large amount of saccharine matter con-
tained in these compounds. Dr. Prout, in experiments made
with the same end in view as Dr. Smith's, found that the
carbonic acid was excreted in diminished quantity, but that
after the lapse of two or three hours from the time the alcohol
was taken, it was very considerably increased.
That the blood contains an excess of carbon, whether de-
rived from the alcohol, or consisting of that which in the
usual order of healthy changes ought to have been extruded
from the system, is certain. This fact is, in some degree,
illustrated by two symptoms noted by Dr. Smith. He says,
"the respiratory muscles acted in a gasping manner, so that
there was a pumping and quick expiratory eflfort in the earlier,
and a lazy feebler expiratory effort in the later, stages." And
again he remarks, " at all periods there was a sense of impedi-
ment to respiration." That such is the condition of the blood
is still further corroborated by two cases of spasm of the glottis,
arising from an excessive use of alcohol ; the one is reported
in the Medico-Cliirurgical Transactions for 1837, and the
other in the Ediriburgh Medical and Surgical Journal for 1833,
and both are re-produced in Dr. Marcet's work previously re-
ferred to (p. 20). The former recovered after tracheotomy; the
other was fatal In the first, the respiration had a shrill tone
and was extremely difficult — ^the patient was perfectly comatose.
Tracheotomy was followed by an immediate cessation of the
violent efforts of the respiratory muscles, and the subsidence of
the venous distension around the head and neck. In half an
hour the breathing was regular. In the second, the post
mortem appearances showed that " both lungs were congested
with dark fluid blood ; dark blood was found in the ventricles
of the heart ; the blood of the veins generally was fluid and
dark coloured." The symptoms in both cases, and the post
mortem appearances in one, resembled those in cases of asphyxia,
from the presence within the circulation of some gaseous poison.
30 0 Observations on the Physiological and
Here, probably, they may be assigned to three causes, the
common results of alcohol, — First, to deficient innervation giving
rise to a feeble semi-paralysed state of the muscles of respira-
tion. Secondly, to the retention within the blood of that carbonic
acid which ought to have passed off in respiration. And,
Thirdly, to the " presence of alcohol within the circulation by
interfering with or checking the action of air in the blood
within the circulation giving rise to a morbid condition incom-
patible with the maintenance of life" (Marcet, op. cit, p. 25).
From the facts I have now laid before you, we may, I think,
conclude that alcohol has the property, first, of deteriorating the
quality of the blood ; secondly, from this cause, and also by virtue
of the affinity which nervous and especially cerebral matter has
for it, it gives rise to a narcotised state of the brain in par-
ticular, and of the nervous system in general ; and, thirdly, that
it is conveyed through the body both in the circulation and
along the nerves.
Eeceived into the blood, altering its physical constitution,
and impairing nervous power, alcohol must influence in a
greater or less degree every organ of the body ; and we find
that it does so.
From the liver alcohol has been distilled where death has
occurred during intoxication. By its presence in this organ,
the structure is directly irritated, while its functional activity
is abnormally increased by the deficient power of the respira-
tion. The effete matters, which we have seen to be retained
in the circulation, not being passed off at the lungs, are thrown
upon the liver. The ultimate result of this physical and
physiological excitement is undue and irreparable waste of
tissue. Contraction, therefore, takes place. In other cases,
where the alcoholic beverage indulged in contains a considerable
quantity of saccharine matter, fatty degeneration of the struc-
ture ensues. The accumulation of this morbid material gives
an appearance of bulk ; the organ is said to be hypertrophied.
In reality, its size is diminished ; the fat giving to it its ap-
Therapeutic Effects of A IcohoL 301
parent enlargement, being in part derived from a change in a
decay of its natural tissues.
On the stomach alcohol acts mainly, first, as a topical irri-
tant ; and, secondly, as a paralyser of its nervous supply.
Passing unchanged through the kidney, it excites a degree of
congestion, depending, as in the liver, partly on its irritating
character, and partly on the excess of functional activity de-
manded by blood containing alcohoL From the urine of per-
sons who have recently taken spirits, alcohol has been obtained
in a more or less notable quantity.
To one other series of experiments do I wish briefly to allude
before passing to notice the theories offered to account for the
mode of action of alcohoL I refer to the investigations of
Messrs. Lallemand, Perrin, and Duroy, and their recently pub-
lished counterpart, the experiments of M. Baudot. I have
already shown that alcohol is deposited in various organs, and
that it is thrown out from the system through the renal secre-
tion. Dr. Edward Smith has demonstrated its extrusion
through the skin. Messrs. Lallemand, Perrin, and Duroy have,
in an academical prize essay, proved that, in addition to these
channels of elimination, it is passed off in respiration, and that
it can be detected in the breath some hours after having been
drank. By experimenting upon the various products of excre-
tion, they recovered about 28 per cent, of the alcohol that had
been taken. Finding no evidence whatever of the conversion
of the remaining 72 per cent., they conclude that it escaped
from the economy in a similar manner to that which they
secured, but that owing to the imperfection of chemical appli-
ances, the length of time elapsing before the whole of the
alcohol is extrudefi, and other sources of error in calculation,
they failed in its detection. These experiments' have lately
been called in question by M. Baudot in a series of papers
published in i' Union MMicale. M. Baudot, it appears, failed
to discover any very appreciable quantity of alcohol either in
the breath, the perspiration, or the urine, and hence asserts the
302 Observations on the Physiological and
conversion, or oxidation of alcohol within the body. M. Perrin
defends tlie experiments contained in the work of which he
Avas a joint autlior; endeavours to show why he and his col-
leagues did not find more of the alcohol taken than they did ;
adduces a series of arguments to prove that alcohol is not an
aliment, and points out what he considers its uses and value.
From tlie observations of Ogston, Percy, and others in this
country, and the French authors just named, we gather that
alcohol accumulates in several organs, more particularly in the
brain and liver; that it remains in the system for a certain
length of time, this depending probably on the amount taken,
the circumstances under which it is taken, and the individual
powers of re-action ; that during its retention it gives rise to
certain functional changes, producing, according to their in-
tensity and duration, more or less alteration of structure ; and
that, ultimately, a great portion, if not the whole, is expelled
from the organism through its several emunctories. Dr.
Marcet is of opinion " that a large portion of the alcohol con-
sumed by habitual drinkers is not at all absorbed by the blood,
but that, after undergoing certain chemical changes, it is elimi-
nated through the intestines with the other excreta " (pp. cit,
p. 1 9). Possibly a considerable portion of that which escaped
the notice of the French observers may have passed off in this way.
Such are the principal well ascertained and clearly established
facts regarding the action of alcohol on the animal economy.
By the light wliich they afford must we be guided in attempt-
ing to deteimine the character of this action, and from them
must we learn when and where the selection of alcohol, as a
remedy, will best avail us in our efforts to check the advance
or prevent the occurrence of disease. I believe the details I
have advanced are perfectly competent for the attainment of
tliese two ends. For, though nearly all the symptoms observed,
all the pathological changes noted, and all the results of physio-
logical investigations that have accrued, either from unusually
considerable doses of alcohol, or from smaller ones taken under
Therajpeutic Effects of A IcolioL 303
somewhat exceptional circumstances, still, as Dr. Edward
Smith remarks, " the dose only affects the degree and not the
direction of its influence." As with all drugs, so with alcohol,
it is with the direction of its action that we are mainly concerned.
Several theories explanatory of the action of alcohol have
been advanced. By some it is supposed to be a Food. Those
who have regarded it in this light have endeavoured to show
that it affords material for the maintenance of animal heat ; that
it is the nutrient, par excellence, of nervous matter, and that it
is a source of the supply of fat.
Liebig, in his well known work on Animal Chemistry wdiS, I
believe, the first who assigned to it the property of maintaining
animal heat. Assuming that, when received into the stomach
and absorbed by the blood vessels, it was there decomposed into
its chemical elements, he inferred that the large amount of
carbon and hydrogen thus supplied united with the oxygen of
the atmosphere to form carbonic acid gas and water, and that
this union, or combustion of carbon and hydrogen, gave rise to
heat. That in fact alcohol was burnt off in the function of
respiration. This theory, it will be at once obvious, is one purely
chemical in its basis ; one wliich omits all consideration of the
physiological action of the spirit. The fallacy of the doctrine
lies in the assumption that decomposition takes place after the
fluid has entered the circulation. No such change has ever
been demonstrated ; while, on the other hand, the experiments
of Messrs. Lallemand, Perrin, and Duroy, with those of Dr.
Edward Smith, tend to show that alcohol, so far from being
decomposed, escapes from the system in its original state. And,
again, were it a fact that it was resolved into its chemical
elements, and burnt off at the lungs, the carbonic acid evolved
during respiration should certainly be in very considerable
excess over its normal proportions. But Dr. Smith has con-
clusively proved that no such excess can be detected. Is it,
howeiver, true ? Does practical observation show that heat is
developed by means of alcohol? The experience of arctic
3 04 Observations on the Physiological and
travellers — so repeatedly quoted as to render specific reference
unnecessary — has shown that the severe cold of the regions in
which they sojourned, was better borne, was less felt, when
spirits were abstained from than when indulged in. Dr. John
Davy tells us that, both in England and the Barbadoes, he
found wine to have a positively depressing influence on the
temperature of the body — a depression which increased in pro-
portion to the amoimt of stimulant taken. Dr. Edward Smith
concludes from his investigations that " alcohol does not increase
the production of heat by its own chemical action, but in-
directly," by lessening the action of the skin, and thereby
reducing the loss of heat. Ultimately, however, in its secon-
dary action " it varies the balance of the circulation at the
centres and superficies, and interferes with the production of
heat." These facts appear to me to entirely negative Liebig*s
theory, and to show that the sense of heat following the use of
alcohol is similar in many points to that resulting from fever,
giving place, after its primary action has passed away, to a
sense of chilliness far more persistent than the previous warmth.
Secondly, by the late Dr. Todd and others, alcohol has been
supposed to be a special nutrient of the nervous system. Here,
again, the basis of the argument is found in its chemical con-
stitution. " Alcohol is, as you are aware," says Dr. Todd, " a
hydrocarbon; aud almost all hydrocarbons have a marked
affinity for the nervous system compared with the other
structures of the body, and it is upon the nervous centres that
alcohol exerts its primary influence. At first its action is
simply to augment nervous power" {op, cit, p. 455). True it
is that alcohol exerts its primary influence upon the nervous
system, but this influence is very far removed in its nature from
that of a nutrient. Dr. Smith remarks that " there is no evi-
dence that it increases nervous influence, except the action
upon the heart and the elevation of the spirits be r^arded as
such ; whilst there is much evidence that it lessens the nervous
power, as shown by the mind and the muscles." All physio-
Therapeutic Effects of A IcohoL 305
logical investigations, all pathological studies tend to show that
it is deterioration not generation of healthy nervous force that
results from the affinity of alcohol for cerebral matter.
The supposition that alcohol loads the blood with fat
globules, the fact that the chemical composition of alcohol and
fat are allied to that of nervous structures, and the known
narcotic property of spirits, have led Dr. Eutherfurd Eussell in
his very interesting and practically useful Essay on " Diet'* to
infer the probability of its nourishing and cherishing the ner-
vous System. In answer to these three reasons on which the
theory is advanced, it may be urged, — first, that the globules
seen in the blood which have been supposed to be fatty are, in
reality, imperfectly formed red corpuscles. The highest stage
of the blood globule being prevented development by the
circulation of alcohoL In the second place, the chemical
likeness existing between fat, alcohol, and brain would be
fair evidence enough of the power of the two former to sup-
ply nutriment to the last, if supported by physiological proof
that the brain was nourished by spirits, wine, or beer, but
standing alone, imsupported by physiological evidence, it is
valueless in interpreting the action of alcohoL Thirdly, the
narcotic effect of alcohol is simply one of its poisonous results.
During healthy normal sleep the wearied brain is nourished, is
re-invigorated. But who will contend that the same desirable
end is attained during the narcotism of alcohol, of opium, or of
chloroform ? Will sleep so induced avert the " nervous starva-
tion " which. Dr. EusseU quotes Dr. Buckmll to show, gives
rise to insanity ? On the contrary, it is the frequent occur-
rence of the alcoholic and the opiate coma, that in a large
proportion of instances gives rise to this fearful disease.
Alcohol does most certainly modify nervous action, but it
cannot nourish nervous matter, or for more than a very brief
period elicit nervous power.
The theory that alcohol is a source of fat appears to have
taiaea from its hydrocarbonaceous composition, and from the
20
306 Observations on the Physiological and
fact that persons in the habit of indulging largely in beer,
porter, and some of the richer wines, exhibit a tendency to
obesity. Such a condition is, however, not necessarily, nor,
indeed, probably, due to the alcohol they contain, but rather to
their saccharine elements. Such persons usually live well in
other respects. The drinker of whiskey and gin, where alcohol
exists in greater freedom from purely nutrient substances, is a
thin, spare, and oftentimes prematurely aged-looking person.
But where fat is deposited, is its presence a manifestation of
superior vitality ? Certainly not. It exists " not in addition
to but instead of, the normal tissues " {Carpenter), It is found
chiefly encumbering the liver, occupying the place of its healthy
structure, and also in the omentum. The deposition of fat in
these cases is an instance of fatty degeneration, rather than of
strong robust health. How rapidly do such subjects succumb
to acute diseases; especially to those where the blood is
poisoned by the taint of typhus, small pox, and erysipelas.
The London publicans, draymen and others, may be large and
to a great extent — depending, however, on the amount of
physical exertion they undergo— powerful men ; but they are
not types of health.
" Food," liebig remarks in his Letters on Animal Chemistry
(p. 479, 4th ed.,) ''should exert neither a chemical or peculiar
action over the healthy frame." Judged by this standard
alcohol certainly^ is not food. There is no evidence to show
that it is a supporter of animal heat ; there is none to prove
that it nourishes the nervous system ; and though some alco-
holic fluids, by virtue probably of their other contents, do tend
to an unhealthy accumulation of fat in some parts of the body^
there is no reason for attributing to alcohol itself the power of
adding, by the production of fat, to the nutrition of the tissues.
By virtue of its power to destroy life alcohol may be justly
regarded as a poison, and as, in the language of Dr. Taylor,
'' medicine in a large dose is a poison, and a poison in a small
dose a medicine ; " it must for all practical purposes be treated
Therapeutic Effects of Alcohol. 307
as a medicine. It is an agent capable of producing certain
morbid conditions, a medicine remedial of disease, and not in
any way a substance competent to afford pabulum for tlie
growth of animal tissues. In short, while it fulfils all the re-
quirements of a medicine of great value, it presents no chara-
teristic of a food.
From its primary stimulating action on the circulation, and
its secondary depressing influence on the nervous system, it
holds a place in the current Materia Medica as a stimulant-
narcotic ; and, in accordance with the conditions supposed to
indicate the necessity for such a dnig, it has generally been
prescribed.
More definite explanations of its modus operandi have been
attempted. Two theories have been made especially prominent ;
these I will briefly describe.
Dr. Chambers, Dr. Hammond^ Dr. Ludlam, and others regard
alcohol as an arrester of metamorphosis. That an arrest of
the normal waste of tissue takes place in health is, however,
rendered very improbable by the experiments of Dr. Smith, as
well as by those other consequences of using alcohol I have
already detailed. Dr. Chambers draws his conclusions from
very slight, and for all practical purposes useless, experiments
of his own, and from a more careful series of observations by
Dr. Hammond, of the Federal Army, in the American States.
In all these experiments the supposed arrest of destructive
metamorphosis was, within a brief period, followed by critical
evacuations. A result which proves that the changes assumed
to have been checked, in reality occurred ; but that the debris,
instead of being cast out of the system in the several excre-
tions, was retained within the circulation for a time to be cast
forth when reaction set in. As all the investigations of Dr.
Chambers were brought to a summary conclusion, when the
appetite was spoiled, or the usual diet was prevented being
taken with pleasure, we cannot from them show that these
changee, besides occurring, were in reality increased ; but the
20*
308 OhservoUions on the Physiological and
observations of others lead us to infer that they were sa
Healthy metamorphosis requires for its complete performance a
healthy blood blastema, a healthy state of the nervous system,
and a normal development of nervous power. These condi-
tions are absent in a man whose blood is charged with al-
cohoL Healthy metamorphosis is, therefore, impossible; and
all lengthened experiments tend to show that the unhealthy
metamorphosis induced takes the form of an excessive, not of a
diminished, waste.
Dr. Beale, (British Medical Journal, October 10th, 1863)*
holds that " alcohol does not act as a food ; does not nourish
tissue," as his late distinguished colleague Dr. Todd maintained
that it did, but that by " altering the consistence and chemical
properties of fluids and solids," it checks that " increased ac-
tivity of the vital changes " which he regards as characteristic
of many morbid processes. Such being those which take place
in exhausting diseases, where, as in the formation of pus, cancer
and the granular cells, a large amoimt of pabulum intended for
the nourishment of healthy tissue is rapidly wasted. There is,
it will be seen, comparatively little difference between the
views of Dr. Chambers, and those of Dr. Beale. The latter
generalises from the effects which he has seen to follow the
prescription of alcohol in disease; entirely ignoring its action on
the healthy man. Such a mode of determining the nature of
drug action must always be unsatisfactory, and very generally
unsound in its conclusions.
In health alcohol produces as its specific effect an abnormal
waste of nervous tissue ; the expenditure of nervous power is
greater than normal metamorphosis can meet. This, I think,
the observations and experiments I have laid before you this
evening fully sustain. Further, all clinical experience teaches
that the sphere of alcohol in disease is to be found where
nervous exhaustion, undue waste, or expenditure of nervous
power are the prominent indications of danger. To such
morbid states alcohol is therefore manifestly Homoeopathic.
Therapeutic Effects of Alcohol. 309
Its mode of action is simply that of all tme, direct, specific
remedial agents. Nor has this similarity between the symptoms
arising horn alcohol used in health, with those for the cure of
which it is so generally prescribed, been altogether overlooked.
Curiously enough it is in the writings of Dr. Brinton — a
gentleman who seldom fails to seize an opportunity of sneering
at Homoeopathy — that we find the Homoeopathicity of the
action of alcohol most clearly asserted! Discoursing on al*
coholics in his work on Diseases of the Stomach (p. 378), Dr.
Brinton remarks, *' in short they are sometimes useftd remedies
against the very ailments which their abuse (or even their
moderate use) can otherwise bring about; a statement which,"
and mark the words, ''while it involves no inherent improba-
hility rests upon an empirical basis such as defies disproof."
Regarded, then, in what I have endeavoured to prove its
true light— as a medicine — ^to be used on the same principle
as all others should be — as a Homoeopathic remedy — we shall
find the sphere of alcohol in those cases, or rather parts of cases,
where the indications of danger arise from exhaustion pro-
ceeding ficom an overstraining of the powers of the nervous
system. An ordinary fainting fit is a fair type of such. A
sudden shock or prolonged drain upon this portion of the or-
ganism gives rise to rapid and extreme waste of nervous force,
with quickened but depressed circulation. In softening of the
brain similar special waste is going on ; upon it likewise de-
pends the exhaustion horn protracted lactation, from long con-
tinued diarrhoea, ficom hemorrhage, as weU as that witnessed in
the later stages of fever, where the heart's feeble impulse, and
the low muttering delirum, with it may be profuse perspirations,
point to the nervous centres as rapidly giving way. In each
of these instances, many other might be quoted, alcohol is in-
dicated as the most probably curative remedy, because it pro-
duces a condition similar to that to be removed. Let me not,
however, be misunderstood; I do not say that alcohol is
Homoeopathic to diarrhoea, and the other diseases named, but
310 Obaervatioiu on the Physiological and
that it is so to the consequence of their recent existence — ^to
the exhaustion they produce.
Further, it is remedial, so far as a drug can be remedial, to
that exhaustion which foUo-ws unusual mental or physical
exertion. It will not, if taken prior to any great effort being
made, prevent the resulting fatigue ; on the contrary, it will
tend rather to increase it ; but the labour having been under-
gone alcohol will, by virtue of its Homoeopathic relationship to
excessive expenditure of nervous force, remove it more rapidly
than rest and food alone will do. A man cannot be primed
for work by brandy, but he may be freed in a very great degree
from its cost to himself by subsequently taking it.
DISCUSSION.
Mr. Cameron, after complimenting the author on the excel-
lency of his paper, which he considered one of the best that had
ever been presented to the Society said : — In studying the phy-
siological and therapeutical phenomena of alcohol, two questions
prominently demand our attention. 1st. Is alcohol an aliment or
not ? In other words, is it decomposed in the system, or simply
absorbed unchanged? 2ndly. Is alcohol a stimulant or an
anaesthetic ? Early in this century, it was proved by direct ex-
periment, that alcohol was capable of causing intoxication when
introduced into the veins or serous sacs of an animal, but Brodit3
and others soon afterwards ascertained that, although intoxica-
tion could be produced in this way, the full poisonous eflPects of
alcohol — the shock to the nervous system which causes death,
could only be obtained when it was taken into the stomach.
Hence, they concluded that its full effects were to be referred to
its action on the extremities of the nerves in its unaltered form.
At this time all vital actions were explained on chemical prin-
ciples, and it was therefore asserted that because spirits of wine
coagulated albumen, it was impossible that alcohol could be ab-
sorbed into the blood in its original form ; but notwithstanding
these a Tpriori dicta, Dr. Ogston detected alcohol by its smell in
the ventricles of the brain, and Dr. Percy soon afterwards found
it, by the same evidence, in the substance of the brain, and made
the discovery, afterwards so important, but whose value was not
then appreciated, that a kind of afiinity existed between alcohol
and cerebral matter. These gentlemen relied on their sense of
smell alone in their researches ; but other investigators followed.
Therapeutic Effects of Alcohol 311
who discovered pure alcohol in the fluids of animals by chemical
agents. The authority, however, of Tiedmann, Gmelin, and
Bouchardat, and others, and more lately that of liebig, who be-
lieved that alcohol was decomposed in the system for the purpose
of maintaining animal heat, was arrayed against those who sup-
ported the views of Percy and Ogston. Duchek, one of Liebig's
pupils, actually described the several changes undergone by al-
cohol in its stages towards combustion, becoming Aldehyde,
then Acetous Acid — ^then Acetic Acid — then Oxalic Acid, and
finally Carbonic Acid. This brought on the famous controversy
between Duchek and Masing, in which the latter set aside the
validity of the experiments of the former, and proved the pre-
sence of alcohol in the bodies of dogs killed by it, by the effects
of a stream of air passed over them into a solution of Bichromate
of Potash and Siiphuric Acid, which is turned into an emerald
green by the action of alcohoL The French chemists Lalleman,
Perrin, and Duroy taking up these experiments of Masing, have
tested the smallest proportions of alcohol in the breath, urine,
&c., &c., in its unaltered form. In this way proofs of the ex-
halation of alcohol have been readily obtained by enclosing the
arm of a man who had drank only one glassful of brandy. In
short, there can be no doubt, even if we were disposed to dispute
the evidence of our senses of smell and taste, that the absorp-
tion of pure unchanged alcohol into the blood is clearly esta-
blished by chemical tests. This fact, then, answers in the
negative the first question — Is alcohol an aliment, by proving
that it passes out of the system, imchanged and undecomposed.
Is alcohol a stimulant or anaesthetic ? A stimulant is a substance
which drives on the actions of the nervous system at an in-
creased speed. Powerful as all the effects of alcohol are, it is very
doubtful whether it ever acts upon the system in this way. On
the contrary, its modus operaridi seems to be anaesthetic, as the
experiments of Dr. Edward Smith prove. He found the primary
effects of brandy to be "lessened consciousness and lessened
sensibility to light, sound and touch ; then stiffness, with feel-
ing of swelling of the skin, particularly of the face, relaxation of
the dartos and other muscles of the reproductive system, and of
the sphincter of the bladder, causing that constant micturition
which those under the influence of alcohol exhibit. The quantity
of carbonic acid from the lungs, and of urea and sulphates from
the urine is diminished. The apparent surexcitation of the
mental faculties and energies which follow the use of alcohol
could easily be shown to illustrate its anaesthetic nature. It has
been proved that the addition of a little alcohol to the usual diet
of a man who previously took none, increased the weight of his
!412 Observations on the Physiological and
body half a pound in five days. The use of a similar quantity of
alcohol with such a diminution of the food as had previously been
ascoii^ained to be capable of reducing the weight at the rate of a
(piarter of a pound daily, was found sufficient, not only to arrest
this diminution, but to add slightly to the weight This is the
true use of alcohol. It is an anaesthetic — it diminishes the
metamor])hosis of the tissues — ^it arrests waste. We can thus
explain the beneficial results of alcohol in continued and other
low fevers. It docs good, not by directly stimulating and
i*ousing the vitality and dormant actions of the body, but by ar-
resting waste, and thus conserving the powers of life until such
time as the patient can digest and assimilate proper nourishment
1 cannot conclude without directing the attention of the society
to the unconscious testimony borne to the Homoeopathic principle
by T)t. Marcet and the other physicians who have followed him
in prescribing Oxide of Zinc in Delirium Tremens. This
medicine causes in the healthy subject, nausea, giddiness, black
specks before the eyes, rumbling noises in the head, faintings,
tremblings, &c. These are leading symptoms of Delirium
Tremens, and for their cure this medicine, in very small doses, is
now regarded as a specific by our Allopathic brethren.
Mr. F. H. Smith thought the paper a very able and in-
teresting one, the only defect was that the therapeutic bear-
ings of the subject were too slightly passed over. The facts
and arguments contained in the paper confirmed an opinion he
had long entertained, that medical men were much to blame,
inasmuch as for the most part they rather encouraged than
discouraged the drinking habits of the community. The writer
of the paper had adduced evidence that the habitual use of
alcohol lowers the vital powers, induces a carbonized condition
of the blood, and renders travellers less able to bear fatigue and
vicissitudes of temperature ; facts which his (Mr. Smith's) ob-
servations and personal experience enabled him readily to under-
stand. He did not habitually use alcoholic beverages, and when
occasionally he took a small quantity, the Gist effect he found
to be stimulating, the second depressing. He did not, however,
agi*ee with one of the previous speakers in considering alcohol
a direct sedative. He thought it bore an analogy rather to
opium than to hydrocyanic acid in its symptoms. The primary
effect of a small dose of opium — say a quarter of a grain — ^was
evidently stimulating ; but when two or three grains were taken
the secondary or sedative effect was induced so rapidly that the
primary or stimulating effect was scarcely observable — ^thus
bearing a close analogy to the .symptoms produced by a large
dose of alcohol. He believed from many years' observation that
Therapeutic Effects of A Icohd, 813
the habitual use of alcoholic drinks was geneially unnecessary,
and that a proclivity was thereby induced to various forms of
disease.
Dr. Drury felt much indebted to Mr. Pope for the interesting
and instractive paper that had just been read. The difficulty of
deciding on the primary action of alcohol was very great ; his
own opinion was that the quantity taken decided the point ;
a small quantity stimulating, a Is^ei quantity, at first de-
pressing, afterwards exciting; a very large or poisonous dose
causing very great depression. It was a valuable remedy, as it
checked waste of the tissues, increased the animal heat, and in
cases of exhaustion or syncope, roused vitality by its stimulating
action. The quantity borne depended on the state of the
patient Thus, in a case of uterine hoemorrhage, he had given
a pint of brandy in the space of about two hours, te a lady who
at other times could not teuch it. Humanly speaking, there
was no doubt she owed her life to this remedy. In fatty disease
of the heart small quantities of spirits with water suited better
than other stimulants. In some forms of dyspepsia a little
weak brandy and water could often be taken when ale or wine
disagreed. Though advocating the moderate use of stimulants,
it would be wrong to avoid expressing a very strong condemna-
tion of the enormous quantity of ale or beer some men took ;
it was wasteful and hurtfuL One could not fail being astonished
at the great quantity some workmen took ; even gentlemen who
dined in the City, as a rule, felt it necessary to ask for a pint,
though often half that quantity might be quite sufficient ; the
accustoming the stomach to take more than it required could not
but be injurious. Moderation was good in all things, but in
few more so than in this. Mr. Smith points out the difference
between the primary and secondary action of opium, which Mr.
Cameron has rather overlooked. In giving alcohol in illness
it was of consequence to know when to give it Thus in the
deliriimi of fever, when some might dread excitement, Dr.
Stokes, of Dublin, chose that very sjmptom as his indication
for giving stimulants. Where such a rule as this, founded on
experience, is laid down, it is a very valuable help. Though
the amount given must stUl be regulated by the experience
of the practitioner, and the effect in each case.
Dr. EusSELL said, — He entirely concurred in the high terms
of appreciation used by Mr. Cfimeron, whose knowledge of the
subject made his opinion of great value, in reference to the learn-
ing and talent displayed by Mr. Pope in the essay they had just
h^uxL At the same time, he was not altogether convinced that
the views expressed by Mr. Pope and endorsed by Mr. Cameron,
314 Observations on the Physiological and
were quite correct. It seemed to him (Dr. Eussell) that the
question should be looked at from two distinct points of view,
first, as one of diet, and then as one of therapeutics. In regard
to the former, he would prefer deriving general conclusions from
the immense field of observation which lay open to them in
history, rather than from the deductions of modem chemists.
The use of alcohol in some form or other, was coeval with the
earliest records of the human race. It seemed to him somewhat
parodoxical to maintain that an article of diet on which mankind
had thriven for many thousand years, was a poison. Surely such
a term was misapplied ! surely there must be some fallacy in the
chemist's view of the question ! He conceived that there was
this fallacy. The chemist dealt with dead matter, not with
living ; man to the eye of the chemist was a compound of oxy-
gen, nitrogen, carbon, phosphorus, sulphur, &c. ; but man to the eye
of a common observer was something far different ; he was living
spirit incorporated into a living body, each acting and re-acting
on the other. Now it may be true that the wine we drink does
not, as the chemists tell us, form any portion of any tissue of our
bodies ; nevertheless, it may materially affect the formation of all
the tissues by exhilarating what in old phraseology were called
the animal spirits, and inducing what might be called a happier
nutrition. How different is a meal eaten in silence and sadness,
to the same meal enjoyed in pleasant society. The judicious and
moderate use of stimulants may propitiate the digestive powers
by stimulating them to the proper pitch, and may thus, although
not themselves nutriments, enable more nutrition to take place.
At all events, this is a question which must be decided by ob-
serving the effects of such substances on living men, and can
never be settled by distilling dead dogs. In regard to the use of
wine, beer, and spirits medicinally, there is perhaps no greater
test of the practical tact of a physician, than his management of
these confessedly dangerous weapons. We have all seen and
heard of many illustrations of the danger of medical practitioners
being led away by a crotchet, and either insisting upon total
abstinence even from food, much more from stimulants, and on
the other hand, of others following the opposite plan, and stimu-
lating immensely in all cases. Both extremes are equally
dangerous. The surest indications for the use of stimulants were
derived from the state of the pulse. The pulse was not made
the subject of such refined study as it used to be ; it required a
highly educated finger to read the pulse aright. We owe much
to Drs. Stokes and Graves, for their valuable instructions in
regard to the use of wine in fever, as well as to Dr. Alison and
others. What they insist on is, that we should ascertain the
Therapeutic Ejffects of Alcohol. 315
condition of the heart. It was stiggested by Mr. BL Smith that
the use of alcoholic liquors induced fatty heart. This may be so
in some instances, in others, however, the judicious use of stimu-
lants seems to arrest the progress of this disease, when it arises
firom insufficient innervation. Besides being guided by the state
of the pulse, we must narrowly observe the condition of the
brain. We are apt to be deceived in the symptoms of this organ,
and to set down to a state of over-action phenomena due to a
condition of want of nutrition. The delirium of a person in a
state of starvation resembles that of one intoxicated. In the
management of incipient puerperal mania, which used to be con-
sidered as an inflammatory condition requiring depletion and
abstinence, the modem practice enjoined by Dr. Simpson is free
stimulation and feeding, — ^and so it is in many other affections.
Mr. Teldham said, — ^Few subjects associated with medicine
were of more importance than that which Mr. Pope had brought
under the notice of the Society in his interesting and able paper.
In spite, however, of Mr. Pope's arguments, he preferred Leibig's
explanation of the action of alcohol to emy other he had met
with. That explanation was, to his mind, thoroughly consistent
with all the known phenomena of alcohol, both in health and
disease. It was, in brief, a decoyer of oxygen into the system.
The affinity between oxygen on the one hand, and carbon and
hydrogen on the other, was the great motive power in respira-
tion ; and in alcohol we had a hydro-carbon in the fittest con-
dition for instantaneous absorption into the circulation. This
rapid absorption explained some phenomena of its action, which
else were unaccountable. For, observe, whilst other carbonaceous
substances — ^fat, oU, &c., had a tissue — ^the adipose— devoted to
their reception, where, as in a store-house, they were deposited
untU required for combustion, alcohol had no such depository,
but was carried directly into the circulation. What followed ?
This, — ^when it was taken rapidly, and in a large quantity, it
produced the phenomena of drunkenness. It was poured into
the system faster than the lungs could bum it ; part of it was
consumed ; part passed off in the breath unconsumed, imparting
to it its own odour; whilst another part, circulating in the
blood unchanged, induced on the biain the symptoms of poisoning
by carbon. Now, change the conditions; let a man imbibe
alcohol in equal quantity, but gradually , and he would sit over
his bottle for hours and hours, without exhibiting any of the
foregoing symptoms, for the simple reason that he took no more
alcohol, and no faster, than his system could consume as it was
taken. The two-bottle man was not, after all, so great a wonder
as was sometimes supposed ; he did not walk away with all that
wine under his skin ; he, in fact, carried away but very little —
316 Observations on the Physiological and
he had consumed it as he drank it. Again, cold and pure air,
which contains a large quantity of oxygen, carried off, so to
speak, the effects of alcohol on the system. Hence, coachmen,
and cabdrivers, and sailors could take with impunity quantities
of alcohol, which could not be borne by persons confined in close
rooms. Apply these considerations to the treatment of ex-
hausting disease — hoemorrhage, and fevers — and the same prin-
ciples held good. In both these cases they had loss of power —
in the one from the loss of vital fluid, in the other from the ces-
sation of nutrition ; and, in both, beyond the use of medicines,
the principles of cure were embraced in fresh air, nutrition, and
alcohol — i. e,, carbon internally in the most convertable form ;
oxygen externally to combine with it ; and light food to sustain
the vital powers whilst disease ran its course, and imtil more
suitable food could be taken and digested. One word as to the
period of the day when alcohol could be taken with greatest ad-
vantage. Clearly, as a rule, it should not be taken in the fore
part of the day. The system was then in the enjoyment of the
nerve-power generated during rest and sleep, and did not reqtdre
the stimulation of alcohoL It was then mere surplusage, which
embarrassed the system. But, later in the day, after the wear
and tear of the working hours, substantial food was demanded,
and alcohol would often be indulged in with imj)unity and ad-
vantage. Unless in exceptional cases, he, Mr. Yeldham, was
satisfied, from reasoning and observation, that the custom which
now prevailed with many medical men of ordering alcoholic
drinks for all hours of the day — for breakfast and luncheon as
well as dinner — ^was xmscientific and prejudicial It was rarely
that alcohol, even in healthy persons, could be borne with comfort
on an empty stomach, or before dinner. These remarks, of
course, did not apply to fevers and other exhausting diseases, in
which the administration of alcohol must be determined, both
as to time and quantity, by the condition of the patient. But,
even here, its good effects were best displayed when it was given
in small quantities, rather frequently repeated, and mixed with
light food : beef tea, chicken broth, arrowroot, and the lika In
conclusion, Mr. Yeldham thanked Mr. Pope for his excellent
paper, and for the trouble he had taken in travelling from York
to read it Such acts of co-operation from their provincial
brethren were particularly grateful to, and were much valued by,
the metropolitan members of the Society.
Mr. Pope said : — I do not purpose, gentlemen, occuping your
time with any lengthened remarks on the discussion which has
taken place, but I must tender you my thanks for the flattering
manner in which you have received the paper I have had the
honour of reading. Mr. Cameron remarked that Alcohol was
Therapeutic Effects of Alcohol. 317
not a real Btiinulant, but a depressor of vital action. This I hold
to be true of its action in health. In the healthy man^ as I
have endeavoured to show, it produces general depression, and
especially is this result observed in the nervous system. But on
the other hand, by virtue of this action, emd in strict harmony
with the homoeopathic law, it specifically removes nervous depres-
sion when existing as a morbid product Because, then, in-
creased vitality follows its specific action, it may be regarded as
a stimulant, while in health it is far from being so. Again, it is
an arrester of metamorphosis only when in disease metamor-
phosis is proceeding too rapidly, is in reality waste of tissua It
here restores normal metamorphosis by checking that which is
abnormal and excessive, the very condition to which it gives rise
in health. Mr. Harmar Smith aUuded to the responsibility en-
tailed in prescribing Alcohol in disease. My impression is, that
our responsibility as practitioners of Medicine consists in our
ordering such medicines, and such medicines only, as are needful
for restoration to health ; whatever is needed for this purpose
must be given, without any regard to the future self-control of
our patients. If alcohol is needed for the promotion of their
recovery we ai*e bound to prescribe it, whether when beyond our
control they will continue to indulge in a palatable but dan-
gerous drug, though highly valuable remedy, or whether they
will refrain from it. That is no business of ours. With refer-
ence to the case mentioned by Dr. Drury, I would observe, that
in Dr. Smith's experiments the heart's action was found to be
increased during the first thirty or forty minutes after alcohol
had been taken, and it may be, that by the frequent and free
repetition of brandy, this increased action may be kept up for
some considerable time. Dr. Eussell argued that custom not
only sanctions the use of alcohol, but proves that it is advan-
tageous as an article of diet. That because people have in aU
generations taken more or less alcohol, they must have thriven
upon it. I confess I cannot see the force of the inferenca As
well might it be said that arsenic is a food, is productive of
superior vitality, because the Styrian peasantry have long accus-
tomed themselves to eating it. Doubtless habit enables a man
to do with less harm to himself that which, but for the habit,
would be highly injurious to him. But it by no means follows
that the habit of taking a drug at regular intervals, which, used
only occasionally, would be productive of disease, is a desirable
or health promoting habit, neither can we conclude that it is an
entirely innocuous one. A substance may be, and is, a poison,
without tinder all circumstances inducing its poisonous effects.
Instead of arguing that alcoholic fluids have been constantly
taken because of their health inspiring properties, it a^^^^^s^ \i^
318 Case of Oangrena Senilis,
me that the secret of their general use is to be found in their
palatable nature. Good old port, sound beer, brandy punch, &c.,
are all agreeable to the taste, and therefore are freely indulged
in. When heavy labour, physical or intellectual, has been under-
gone for some time, and the strength to continue it as long as
may be required is failing, a dose of brandy may, by its homoeo-
pathic relationship to the induced waste, check it, and so allow
of the completion of the work. This power is alluded to
by one of the Arctic travellers [Mr. Cameron — ^Dr. Hooker.]
But on the other hand, it cannot produce power anticipatory of
waste. Mr. Yeldham remarked that alcohol was not specially
deposited in any organ. It is not so in a decomposed state
certainly, but in its integrity it finds a nidus in the brain to a
very considerable extent. It is, it is true exhaled, but not as so
much carbon and hydrogen ; it passes off from the lungs as it
entered the stomach, as alcohol. The impunity with which
more or less alcohol is taken is in proportion to the individual
power of evolving it The workers in the Staffordshire iron
founderies, who are constantly in a state of profuse perspiration,
measure their allowance of beer by the gallon, not the pint. In
conclusion, I may remark that while much difference of opinion
evidently prevails as to the modus operaridi of alcohol, we all
seem to agree as to the class of cases in which it is needed, viz.,
those in which danger arises from nervous prostration. This
state I believe alcohol produces in health ; to it therefore it is
Homoeopathic when arising in the ordinary course of diseasa I
again thank you for the reception you have have accorded to my
paper, and at the same time take this opportunity of expressing
the pleasure I have felt in being present here this evening.
CASE OF GAITGEENA SENILIS.
The last illness of Archbishop Whateley.
The public and unconpromising testimony borne by my late
much lamented patient to the truth of our medical creed, ren-
ders it imnecessary to apologise for bringing before the Society
a short notice of the last illness of Archbishop Whateley. One
of his Grace's most remarkable characteristics was an honest love
of truth. This in a mind of unbounded capacity, gave rise to a
strong impulse to investigate every new discovery that came
Case of Oangrena Senilis. 319
before him fairly supported. Having rigidly tested it, and
being once convinced that a subject was based upon truth, he
became its firm and unflinching advocate. He told me that
his final decision in favour of Homoeopathy was due to the
case of a favourite dog, which had been unsuccessfully treated
for many months by veterinary surgeons, and was cured by Dr.
Karl Sutton in a fortnight.
The following memorandum was written about fourteen
years ago, and speaks for itself. It is copied verbatim from
the original in his Grace's hand writing, but unfortunately
bears no date. — " Memorandum : —
" In case of my being seized with any disorder that de-
" prives me of speech or reason, my earnest desire is, that none
" of the ordinary, as they are called. Allopathic practitioners,
" may be called in ; but that Homoeopathy may be resorted to,
" if any one can be found to prescribe, and if not, I may be
" left to nature. And in case of my death, this memorandum
" may be produced as a vindication of my attendants."
The following correspondence between a celebrated Allo-
pathic physician and his Grace, although^ perhaps, known to
the members of this Society, is of sufficient interest to deserve
being recorded hera
''London, 13th June, 1862.
" My Lord Archbishop,
" We are informed that the Eoyal College of Surgeons in
Ireland ordained last August that * no fellow or licentiate of
* the Eoyal College shall pretend or profess to cure diseases
* by the deception called Homoeopathy or the practice called
* Mesmerism, or by any other form of quackery.' * It is also
hereby ordained that no fellow or licentiate of the College shall
consult with, meet, advise, direct or assist any person engaged
in such deceptions or practices, or in any system or practice
considered derogatory or dishonorable by physicians or sur-
geons.* Is your Grace aware of this ?
" I have the honor to remain,
" Tour very faithful servant,
320 Case of Oangrena Senilis,
" My Dear Sir,
" I was well aware of the detestable act of tyranny you
refer to. I believe some persons were overawed into taking
part in it against their own judgment. I have always pro-
tested against such conduct in all departments of life. You
may see something to the purpose in my little penny tract on
'Trades Unions' (to be had at Parker's). In fact, the present
is one of the Trades Unions. A man has a right to refuse to
work, except for such wages or under such conditions as he
himself choose to prescribe, but he has no right to compel
others to concur with him. If there is any mode of medical
treatment which he disapproves of, or any system of education
which he thinks objectionable, he will be likely to keep clear
of it of his own accord, without any need of compulsion or
pledges. Those, again, who may think differently, ought not
to be coerced or bullied. Some persons seem to have a notion
that there is some connection between persecution and religion,
but the truth is, it belongs tg human nature. In all depart-
ments of life you may meet with narrow-minded bigotry, and
uncharitable party spirit. Long before the outbreak of the
Eeformation the Nominalists and the Eealists of the logical
school persecuted each other unmercifully — so have Eoyalists
and Eepublicans done in many other countries ; and in our
own country the Trades Unions persecute any one who does
not submit to their regulations. In Ireland, if any one takes
a farm in contravention to the rules of the agrarian conspi-
rators, he is waylaid and murdered ; and if he embraces the
Protestant faith, his neighbours aU conspire to have no dealings
with him. The truth is, the majority of mankind have no
real love of liberty, except that they are glad to have it them-
selves, and to keep it all to themselves, but they have neither
spirit enough to stand up firmly for their own rights, nor suf-
ficient sense of justice to respect the rights of others. They
will submit to the domineering of a majority of their own
party, and will join with them in domineering over others.
In the midst of the disgust and shame which one must feel
at such proceedings as you have alluded to, it is some conso-
lation to the advocates of the systems denounced, to see that
there is something of a testimony borne to them by their ad-
Case of Oangrena Senilis, 321
versaries, who dare not trust the cause to the decision of reason
and experience, but resort to such expedients as might as ably
be employed for a bad cause as a good one.
Signed, "R Dublin;'
In connexion with the above, I may submit to the Society
the following correspondence : —
"The Palace^ 2Uh Feb,, 1862,
"Deae Db. Scriven,
" The Archbishop's male friends are all very anxious that
he should allow either Dr. A — , Dr. B — , or Dr. H — to see
his leg. He thinks it rather worse, but I should hope that is
only fancy. However, he wishes to satisfy his friends, and
Miss Whately told him that you had not the least objection to
his seeing a surgeon, and he has therefore asked me to beg
you to fix upon which ever you like of these three, and appoint
an hour to-morrow to meet him here. The Archbishop begs
me to add, that he has not the least fault to find with your
treatment of the case. Miss Whately is dining out to-day,
which is the reason that I am writing. The Archbishop told
me that I might write in his name in the third person, but I
thought that I could better explain myself in the first.
" Believe me,
** Tours most sincerely,
«A. S."
To this I replied that I should be most happy that a surgeon
should see his Grace, and named Dr. A — , but added, that I
feared no Dublin surgeon would meet me in consultation.
" The Palace, Monday Night
"Dbae Db. Scriven,
" Many thanks for your kind note, but his Grace cannot
call in a surgeon. Ycm must do it, or it cannot be done at all.
He can have no one who will not meet you. If Mr. A. will
do so, very well ; and his Grace begs me to say that you can
name any hour to-morrow for your meeting here, only let him
know beforehand. As I said before, his Grace is perfectly
21
322 Ca$e of Oangrena Senilis. -
satisfied with your treatment, but to please some of his friends
he will see a surgeon with you — not otherwise.
" Very sincerely yours,
"A. S."
On receipt of the foregoing, I wrote to Dr. A. as follows : —
"Dr. Scriven presents his compliments to Dr. A., and
begs to say that he is in attendance on the Archbishop of
Dublin, who is suffering from a small ulcer on the outer ankle.
His Grace having been urged by some of his friends to obtain
the opinion of an eminent surgeon, Dr. Scriven has named
Dr. A., and would be glad to know at what hour to-morrow it
would be his convenience to call on his Grace. Enclosed is
a note which Dr. Scriven has just received from a relative of
the Archbishop's, at present at the Palace, by which Dr. A will
perceive that his Grace wishes to continue Homoeopathic treat-
ment, so far as his general health may require it.
" 2^th Feb, 1862. " Monday NigUr
25th Feb., 1862.
"Mr. A. presents his compliments to Dr. Scriven, and
reply to his note just received, begs to say, that as his Grace
the Archbishop of Dublin has decided that he will have no
surgeon to visit him who will not meet Dr. Scriven in consul-
tation, Mr. A. regrets that he cannot have the honour of pre-
scribing for his Grace under circumstances which would be a
direct violation of a recent "ordinance" of the College of
Surgeons in Ireland, of which Dr. Scriven is aware."
" Palace, Tuesday Morning.
" Deab Db. Scriven,
" His Grace is so opposed to tyranny in any shape, that
things must go on as they are, and I have no doubt that it is
all for the best.
" Yours sincerely,
"A. S."
He was one of the Vice-Presidents of the London Homoeo-
pathic Hospital, and a liberal contributor to its fimds, as well
as to those of the Dublin Dispensary. His knowledge of botany
and natural history was most extensive ; he was also largely
Case of Gangrena Senilis. 323
acquainted with the uses of herbs as domestic remedies in
different countries. This is not the place to recount his Grace's
literary labours, which are in the possession of the public.
Without further preface, I shall proceed to give a brief history
of the illness which removed from his sphere of usefulness this
truly great and good man at the age of 76.
On the 2nd July 1863, his Grace the late Archbishop of
Dublin, sought my advice for a small blackish-looking spot,
about the size of a fourpenny piece, on the tendo achillis, two
inches above the os calcis, and more than half an inch above where
the upper edge of the shoe pressed. It had existed for a fort-
night before I saw it, and had been poulticed with white lily
root. There was no appearance Of redness or inflammation
around it, nor was there any oedema of the foot at this time.
No mechanical injury of any kind had occurred to which it could
be attributed ; the pain was described as of a burning kind,
and at times stabbing " as if a red-hot gimlet were run into it.**
It may be well to state here, that his Grace had suffered during
the previous seven years from a paralytic affection, principally
of the left side, by which the left leg was much enfeebled.
There was also paralysis agitans of both hands. This infirmity
had come on gradually without any apparent cause, and slowly
and steadily increased, interfering very much with the power of
locomotion, and preventing his taking the amount of exercise
requisite for health, and to which he had always been accus-
tomed. Against this his Grace struggled manfully, and persisted
in taking a daily walk before breakfast and lunch. Of late
his appetite had not been good, but he partook of animal food
three times a day, and took a rather large amount of wine and
other stimulants, including brandy, strong coffee, and snuff. In
the winter of 1861, I had treated a small but most painfully
irritable idcer situated below the outer ankle of the other or
left foot. It yielded to homoeopathic treatment, combined with
the use of the Turkish bath, which his Grace found most in-
vigorating and agreeable, and which he continued to t^V^ ^iXiWiis.
2\*
324 Com of Oangrena Senilis.
once every week or ten days, until confined to his country
residence by the attack now under consideration.
For the symptoms above detailed, Arsenicum 6 was the
medicine first prescribed, and cold water dressing to the sore,
with hot fomentations night and morning. Arsenicum was
continued for a week without any alleviation, and Arnica 3 was
given with Arnica lotion locally. No improvement resulted,
and Secale Cor. 3 was ordered, with a similar result. The
brownish dry patch spread very gradually, creeping downwards
and forwards in the direction of the outer ankle. The foot
became cedomatous, and some swelling appeared in the leg.
Lachesis was next given, and a poultice of linseed meal and
barm applied thrice a day, the foot and leg being bathed in hot
water, when the poultice was removed, and well rubbed and mes-
merised night and morning. The mesmerism appeared to have
a temporary effect in soothing pain. By the first week in
August the sore had extended in the direction of the external
malleolus, and formed a junction with a similar brown patch
which made its appearance on the cicatrix of an old ulcer long
since healed, directly under the ankle. The deeper structures
were beginning to suffer from the destructive process, and the
surface of the tendo achillis became exposed, assuming a dirty
brownish appearance ; there was little or no discharge. There
being considerable foetor which distressed the patient, a layer of
very finely powdered peat charcoal was spread on the poultice,
and Carb. Veg. was given internally. No benefit resulting
from this change, the poultice was discontinued, and several
folds of lint moistened with Hydrastis lotion and covered with
oiled silk was applied, while Hydrastis 3 was given internally.
The oedema and pain increasing; this was after some days
abandoned, the poultice resumed, and as there was much redness
and swelling. Belladonna was given. The redness subsided, but
the swelling continued, and the destructive process extended
up the leg to the extent of four or five inches above the os
calcis and below the outer ankle, while it implicated the whole
Case of Oangrena Senilis, 325
structure of the tendon, whicli became a soft pulpy mass of
brown disorganised fibres, the foetor of which was most offen*
sive. Various medicines having been given in addition to
those mentioned, viz., Mercurius, Plumbum, Causticum, and
China. At the suggestioa of Dr. Blythe, who saw his Grace
frequently in consultation, it was decided to give the first dilu-
tion of China, and the first trituration of Ammon. Carb. in
alternation, and to apply a resinous ointment to the sore.
After some days, no improvement resulting, the simple poultice
was resumed, and to relieve the distressing odour, pieces of lint
wet with a solution of Permanganate of Potash, were placed
outside the other dressings. Some slight diarrhoea that had set
in was immediately checked by Arsenicum. The paralytic
affection to which allusion has been already made, rendered
every attempt to place the leg in an easy position by means
of cushions or splints, while the patient lay on his back, utterly
hopeless. He spent the night lying on the left side, and during
the day, either sat or lay on a sofa on the right side. Although
a recumbent position was most desirable, the paralysis gave
rise to great restlessness, and relief was frequently sought in a sit-
ting posture. The nocturnal left decubitus produced a large blue
threatening looking patch on the left trochanter, which I covered
with Arnica lotion, lint, a pad of wadding, and oiled silk firmly
secured with adhesive plaister. Slight haemorrhage occurred one
morning from a small vessel imder the sloughy mass, which
was quickly repressed by the application of turpentine. Matters
progressed very gradually, but steadily in this manner till the
beginning of September. There was little change in the pulse,
naturally a slow one; the patient slept a good deal, as had
been his habit in health ; much nourishment was taken in the
form of strong beef tea, jelly, pounded meats, claret, port wine,
and brandy. His daUy routine was to get out of bed between
nine and ten ; after going through his ordinary toilet, which he
strongly objected to curtail, and being dressed in his usual
costume, he breakfasted and lay on the sofa. After soma
32() Case of Omigreiia Senilis.
rej^ose his leg was dressed, and he transacted business, frequently
of great importance, and requiring considerable deliberation
with his secretary, and received liis brotlier diocesans, or any of
his clergy who came to visit him. He next took an airing in
the grounds in a Bath chair, and then lay on the sofa, either
sleeping or listening to reading, always preferring some book
of a theological or scientific kind. Natural history was a
favourite subject, and he manifested great interest in the in-
cidents of the American war, and other leading topics of the
day. His intellect and memory maintained their power and
clearness as unclouded as they had ever been. Being very
averse to relinquish his normal habits, he had himself lifted
into a wheeled chair, and took his place at the dinner-table.
In the evening he lay on the sofa, listening to music, which he
much enjoyed, or played at chess or backgammon. It may
easily be imagined what a deep interest was taken in his case
by his numerous friends, and the many prelates and clergy
who venerated his Grace. Innumerable were the panaceas for
"sore legs" suggested and urged upon him, not merely by
letter but pei-sonally, and most pressing were the solicitations
that he would give up " QiLackery" and have a " regular surgeon.'*
His reply to these importunities was characteristic and con-
clusive. Taking an opportunity when a right reverend prelate
and several minor dignitaries with myself were present, he said :
" I have very many kind friends, each of whom suggests a
separate mode of treatment or remedy ; I can make use of but
one, and having made my selection, must be in a minority."
Alter frequent consultations with Dr. Blythe, and the an-
nouncement of our joint opinion, as to the imfavourable nature
of the case and the probable result, it was determined to
obtain the advice of Professor Henderson, who having been
telegraphed for, saw the Archbishop on the 9th of September.
At this time the sore extended across the back of the foot
from one malleolus to the other ; the tendo achillis, and all the
structures down to the bones, were destroyed from the heel six
Case of Oangrena Senilis, 327
inches up the leg. The foot was red and cedematous, the calf
enonnously swollen, of a deep purple red, with two large
yellow bullae on the centre of the calf, and a black patch had
appeared on the front of the leg over the tibial muscles.
There was a large blue patch on each trochanter, surrounded by
vesicles, a similar spot on the left scapula, and several bluish spots
on the toes of both feet from pressure against the other limb
while lying. The pulse had become quick and feeble, the
tongue dry, and there was occasionally severe pain in the
ankle and calf of the leg. Such an array of symptoms in a
broken down constitution at the age of seventy-six, notwith-
standing the soundings of the heart and lungs, impressed Dr.
Henderson most unfavourably, and a fatal result was prog-
nostigated as probable in a week or ten days. He, however,
recommended a less stimulating diet, claret alone, instead of
port wine and brandy, and some farinaceous food and beef
tea. Mercurius 6 was the medicine selected. On the following
day, the whole leg up to the knee was swollen, tense and
^^oS7' I enveloped the limb in cotton wadding, covering the
sloughs with a weak solution of carbolic acid. A water bed
was procured, and his Grace agreed to forego his usual toilet
and confine himself to the water bed. The symptoms of
prostration did not progress, and in a few days, matter of a
most oflFensive smell and brown colour was evacuated by several
incisions, a line of demarcation formed at either side of the
calf and below the popliteal space, and from day to day the
skin and large muscles of the calf separated piecemeal, leaving
a clean granulating surface from below the knee to the heel. This
was all accomplished without haemorrhage or diarrhoea. There
was a good deal of nocturnal fever and some slight delirium,
which Belladonna and Hyosciamus relieved. The local change
was not, however, followed by any improvement in the con-
stitutional symptoms, and debility very gradually increased
feam day to day. The black patches on the trochanter re-
Itained in statu quo, and neither spread, noi didi \\i^ ^^xS^
328 Case of Ganjrena Senilis.
l^afhrT-like sloughs separate. The grannlations on the leg
amiliiwA florid, and the edges in some places showed an in-
clinutioii to fonn skin. lu the first week in October the
t()ii;jti(j beraino drier, deglutition and articulation became more
(iUi\ iiumi (liilicult, and were only performed by the strong effort
of a will. Still the intellect remained dominant and nndonded
iiH v\rr. It wuH a struggle between mind and matter. On
Mm? (Jill OcAaAh^t, this state of things had so far increased that
iiii,i<Milfiliini bc'ciiino impossible, yet by a negative or afl&rmatiye
MJ^jii, liJH (Inuuj was still able to express his wishes to his
iiilt'ndmiiM. It liad been a frequently expressed wish during
hi'ullli, wImmi c()nv(u\sing on the subject of dissolution, that he
mIhiuM not outlive his intellect; and most fully, and it maybe
mu«l, |ininlully, was that wish accomplished. On the morning
nf th(» 81 h, at ton minutes to twelve, the struggle quietly
i'l«»r.tM|.
Tlio innujMliato termination was to a certain extent un-
r\luM'l^^(l, noiH^ of tlu3 usual signs of approaching dissolution
liuvih^ lu^tMi obHiM'vod. It was discovered on my arrival, ten
iniimlpM iiriprwanlH, that a small vessel in the leg had opened,
nihl MtiMl('i(»nt ha»nu)rrlia)j[o had taken place to extinguish the
llu'lNnriMf" lluino that might otherwise have smouldered on for
niiulhor tNsniity-four hours.
I''rnnj Iho coiinuoiuunuont the disease had been regarded as
Monih\ (lani^TtMic, do|MMuhuit on partial or complete obstruction
of m\\\o (»r tlu^ arlcu'ial branches supplying the limb; an in-
ilirttiui^t omnlliko haiHlness was detected in the popliteal space,
but tu>ul(l not 1)0 tracod down the limb. Stethoscopic exami-
uuliou fiUlod to dirtcovor any disease of the heart or large
nrtorial truukH, and the lungs were quite sound. In fact, his
(iraoo frotiuoutly i^emarked that he did not know what a cough
>vaa.
To the mechanical origin of the disease one feels inclined
to attribute the absolute powerlessness of all the remedies
proscribed, not one of which appeared in any way to impress
Case of Oangrena Senilis, 329
the principal malady, although the tendency to diarrhoea, as
well as the fever and delirium, all yielded to the remedies ad-
ministered for them. The healthy suppurative process which
set in subsequent to the visit of Professor Henderson, and the
total cessation of the spread of the gangrene, were very re-
markable, and may possibly be attributable to the completion
of the obliteration of the arteries supplying the calf, and the
establishment of a collateral circulation, which vitalised the
deeper layer of muscles and the front of the leg. As no
anatomical examination of the limb was permitted, this must
remain a matter of speculation ; but it gave rise to the feeling
that had this change been brought about at an earlier period,
before the vital energy had been so lowered, there might have
been some chance of at least a partial recovery.
DISCUSSION.
Mr Teldham rose simply to thank Dr. Scriven for his very
interesting communication; for, as the Chairman had already
observed, it was not calculated to elicit much discussion of a
therapeutic character. Such a communication from a gentleman
who enjoyed the privilege of frequent intercourse with such a
man as Dr. Whately, could not fail to be deeply interesting, —
and Dr. Scriven had ably related what he had observed of the
closing scene of the great man's life. Dr. Whately's reply to the
allopathic physician, was a masterpiece of writing — ^too much
much could not be said in its praise. As regards the medical
part of the paper, he (Mr. Yeldham) thought Dr. Scriven was a
little unreasonably disappointed at the failure of his treatment.
What could he have expected ? Unless they could stop the
course of time, and reverse the order of nature, they could
scarcely hope to do much in arresting the progress of Gangrena
Senilis, which arose from simple failure of vital power from the
lapse of years. The Archbishop could scarcely be said to have
ssiiik from disease — ^his was simply a prolonged death — dying at
the extremities, as an aged tree dies first in its branches. Ex-
cept by nutrition, and judicious stimulation, they could do but
little to arrest the death of old age. Therefore, in the present
case, he would, perhaps, have given the bark and ammonia,
if he had given them at all, in larger doses, purely as stimulants.
Dr. KiDD said, that the memorandum written by the Arch-
bishop, illustrated the largeness of his mind, and the perfect
iW Case of Gangrena Senilis,
vouMonoQ he had in the law, " similia simUibtcs.** The case
was unlortunately oue of those which medical art of any school
coiilvl not ouiv. The gangrene was caused by obliteration of the
artt'iit's ; t\\o result of degeneration, which nothing could cure.
lu surh cast's Dr. Kidd's experience was in favour of keeping
the ^^'iiugn'uous surface j)erfectly dry — avoiding poultices, fomen-
tations, ami h)tion3 — the surface dusted with finely pulverized
ilrv Vv'i:»'tiil>lo charcoal, three or four times a day, and washed
with wariu si>ft water, not oftener than once or twice in twenty-
four hours. The limb should be bandaged with a roller of
l)i>nimctt llaiiuel, which gives a gentle elastic support to the
iiniil'atit>n. lu sucli cases it is most important to bear in
luiiul the nuu'lianical cause of the disease, and therefore to pro-
mi»te tho oiivuhitiou by gentle shampooing of the limb in a
iliriMtiou upwards, and by raising the leg on an inclined plane,
avoiviing standing and walking, but keeping the patient fre-
tiucntly out i>f doors on a reclining couch with the limb raised.
fhani^o of air to the seashore helps to delay the progress of
the disease. The medicine which seemed most truly homceo-
pathie to the cast^ was Secale, and to give the full benefit of the
law aim ilia similibus to his Grace, this medicine should have
bet^i given in the first decimal trituration, and the mother
tincture, as well us in the thinl dilution. Dr. Henderson's advice
ahvuit vliet was most judicious. Much good is often gained by
Uvh^ptiuij: a light diet and weaker stimulants. In a weak state
of health, the stomach and bhn^d became weighed down, so to
speak, anil oppi^esst^d by too strong nourishment or too strong
stimulants. Dr. Kiild narrated a case of gastric fever with
ga:igreni>us \dceration of the legs, in an old lady aged seventy-
tnght, when^ aggravation invariably followed the use of solid
fov>.l of any sort, whoivas on clear beef tea and milk and water,
with a fi'oe use of sherry, the old lady perfectly recovered, to
tht^ astonishment of her friends, who had a hard task to carry
out Wus instructions of refusing solid food, which the patient
asktul for.
Dr. MoKOAN did not agree with Dr. Scrivens's treatment of
tlh) cast). No surgeon would have employed the measures he
adopted. The meilicines best indicated were Secale and Arseni-
cum. Doubtless, under any treatment, the case must have
ttMiuinattnl fatiilly. The cause of death was probably ossifica-
tion of the arteries. He sometimes found even the coronary
arteries produce death of remote parts. He (Dr. Morgan)
agrf>tHl in all the treatment suggested by Dr. Kidd.
Mr. Buck thought all must deeply regret the loss of this
truly estimable and staunch supporter of our cause ; it was rare
to tind one who would so boldly and unswervingly persist
Case of Oangrena Senilis. 331
against a mighty odds in maintaining and defending this, which
he felt and knew to be a great and imperishable truth ; fairly
might we wish his life to have been spared some few years
longer, to have still given his powerful aid to still the opposition
with which we are at times assailed. With regard to the treat-
ment of the case, he did not see that much could be done, but
agreed with Dr. Eadd as to the treatment of gangrene, by
supporting the limb, keeping it dry, and giving such patient
fresh air. Believed Secale to be a most useful remedy; yet
feared, in the case of the Archbishop, whatever plan had been
pursued, the result would have been the same.
Dr. KussELL said, he regretted very much that Dr. Scriven
was unable to be present. He considered it hardly fair to dis-
cuss the treatment of a case in the absence of the practitioner
who treated it ; for in the management of every case there was
always something more or less peculiar to it, which frequently
required that the general rules laid down in books as applicable
to the class to which it belonged should be modified, or even
altogether reversed. It might not be known to all, that besides
having an excellent medical education. Dr. Scriven had enjoyed
the advantage of being an apprentice of the great anatomist and
excellent surgeon, Mr. Harrison, and had the best opportunities for
acquiring a thorough knowledge of surgery. This stood him in
good stead in the present instance, when, owing to the intolerant
measures of the College of Surgeons of Ireland, he was debarred
the benefit of the aid of a professed surgeon. The fact that in
most trying circumstances he succeeded in retaining the fullest
confiilence of the Archbishop and his family, was the highest
testimony we could desire, to the tact and judgment both he and
Dr. Bly the must have displayed ; and we, as a body, may be very
thankful that we had the advantage of being so well represented
in Dublin.
Dr. Chapman (in the chair). — ^The case related by Dr. Scriven
is one of great interest, personal, however, rather than pro-
fessional. The illustrious patient deserved all respect from his
contemporaries, not only on account of his eminent intellectual
faculties and of his moral excellence, but for his consistent as-
sertion of his liberty of human thought and of human action,
for the benefit of mankind, and for the advancement of know-
ledge and of science in whatever direction. There is no scope
for discussion on the subject of Senile Oangrena. The oil that
supports the flickering flame is going out, and soon goes out. It
cannot be supplied in such cases ; whether it be embolism, or
arterial obliteration, the result is the same. The practice of Dr
Scriven has been objected to by one or two, in his treatment of
332 Case of Oangrena Senilis,
this case. He is not present to show why he did this or that;
or why he omitted to do that or this. He had an excellent
medical and surgical education at Dublin and Edinburgh, and
partly in London. — ^We doubt not he did his best to alleviate
wliat lie could not cure ; and the patient and the family were
thoroughly satisfied with and thankful for his treatment. The
physician and the patient showed equal moral courage; the
former had to show patience, and unfailing temper, and con-
scientious reliance on his own resources ; the latter had to resist
the impatience of anxious friends, and to die in and for the main-
tenance of the medical creed, to the practice of which he had
for many years trusted his own mortal life, and the lives of others
dearer to him than his own. There is no use in giving cases,
exemplifying the specific action of such remedies as Arsenicum,
Bellado7ina, Armonium, Carhonicum, China, Carbo Animalis,
Carho Vegetahilis, &c., or of the advantages derivable from
poultices of yeast and charcoal. The Chairman had seen his
full share of cases of the gangrene of age. He saw a few years
ago a case of this sort, remarkable from the presentments of the
affected limb. From the upper part of the thigh to the toes, the
integuments presented the appearance of half-tanned, of half-
charred leather. There was, in this case, the same uneasy
restlessness which is observable in those that go out from
" Bright's Disease of the Kidney." The best palliative in this
instance was brandy in small but frequently repeated doses.
Another case : — A gentleman, not so very old in years, had
gangrene of several toes of one foot ; he was a plethoric man,
full of the consciousness of active life. He was told that he
was to die ; he said " I don't believe it, I don't feel like a dying
man." The final issue was rapid in this case ; he departed this
life in a few weeks. In this case, alcohol, frequently repeated,
but in small quantities, was the chief palliative. There was the
same restlessness in this case as in the preceding. Yet another
case : — An old lady, near 80, had gangrene of one of her toes.
The dead blackness disappeared, but her friends were told the
case was nevertheless mortal, and she went out Kestlessness in
this case also was the predominant symptom. We grow old
while we speak. " Bum loquimur senescimvs" The glory of a
mortal life fades away ; but in the case of worthies something
remains.
" The actions of the just
Smell sweet, and blossom in the dust,
From the time he adopted Homoeopathy, to his last breath — a
period of many years — ^Whately was a staunch HomcBopathist.
He never wavered ; he gave noble, simple, honest testimony to
his conviction that Hotnoeopathy was the law of drug healing.
Observations on afeio Local AncestJietics. 333
He went out, and was satisfied to go out, under the banner of our
law of therapeutics. All honour to his memory ! All praise to
his honesty ! His name will live after him — ought to live so
long as the English language endures, as a ripe scholar, a pro-
found reasoner, an exact logician —
'' Quia desiderio sit pudor aut modus
Tarn carl capitis ? **
OBSEEVATIONS ON A FEW LOCAL AN^aiSTHETICS.
By Dr. Eugene Cronin.
I was induced a short time ago to examine the subject of
local anaesthetics, by seeing the frequency and indiscrimination
with which Chloroform is now used ; and from having in two
or three instances witnessed the bad effects produced by it in
some of the minor operations. Operations which but for the
nervousness of the patient, might have been performed with
comparatively little suffering, and which I think but for the
impatience of the surgeon, would have been rendered sufficiently
painless by the employment of a local anaesthetic. Every agent
by which general anaesthesia is induced produces a powerful
impression upon the system, and may occasion dangerous con-
sequences when freely and carelessly administered ; and even
with the greatest care it appears certain that the inhalation of
Chloroform is in some cases inevitably fatal, and Dr. J. Amott
has statistically proved that the mortality after operations has
materially increased since the introduction of Chloroform.
The title of this communication shows that I have been engaged
only with some local anaesthetics, for of course there are many
agents of this nature. My investigations have been confined
to Chloroform in liquid and vapour, to Chloroform and Acetic
Acid according to the new form of chloracetisation, to freezing
mixtures, and lastly to Carbonic Acid Gas. These of course
can only be expected to act in superficial cases, yet in private
practice the boon of being freed from the horrors of cold steel,
334 Observations on a few Local Ancesihctics.
without encouutering those of the inhalation of Chloroform, is
no small one. I am inclined to believe these various articles
do not produce their effects till an action amounting to one of
revulsion or counter-irritation occurs, since a varying amount of
irritation in all cases precedes the anaesthesia: I mean by
counter-irritation the production upon the surface of a powerful
impression, which seems to be capable of arresting or diverting
as it were the attention of the system, and thus for a time
checking or relieving a morbid process.
It lias frequently been urged that " ancesthetic " is inapplic-
able and untrue with regard to Chloroform; for my part I could
never see the force of the argument used against its employment.
Pit)tessor Hughes Bennett states his argument against the cor-
rectness of the applicability of the word anaesthetic to Chloro-
form thus : — " Looking at the meaning of the word anaesthesia
I find it implies a want of feeling, hence as Chloroform destroys
the sense of touch by first producing loss of consciousness, the
term auiosthesia is inapplicable, and is only employed as a
'* mask to conceal its true action as a stupifying agent." And
again, in his work on the Principles and Practice of Medicine,
page 432, he says : "The modem practice of depriving persons
of coiusoiousuoss in order for a time to destroy sensation, has
boon very much misunderstood, in consequence of such remedies
having boon erroneously and unscientifically denominated anaes-
thotics ; in fact they in no way influence local sense of touch,
tiioir action is altogether central, and hence the danger which
ofton attends their action."
I n answer to Dr. Bennett's argument that the word anaesthetic
luoauvM a want of feeling, I would say that that translation is
l^ulially cori-ect, but if we look at the Greek verb di(T0aVo/iac we
Uuvl that in its strict and true sense it means, "I perceive with
tho aouHOj*," that the cognate aiadnfris implies " perception by
tho {ioua^i44»" and the word avntrdritris itseU, means "stupidity,"
with its oovrt^iipouding verb Ayaitrdrirekt " to be senseless," or
** stui)id."
Observations on a few Local Ancesthetics, 335
I shall here give the results of a few experiments tried upon
myself, accompanied by a few cases : —
ExperiTrunt 1. — I put about a drachm of Chloroform in a
wide tube and applied it to my forearm ; after the application
had been continued for two or three minutes, I experienced
tingling and slight feeling of heat ; at the expiration of five
minutes, on removing the tube the cuticle looked of a pale pink,
the line of pressure from the edges of the tube were very dis-
tinct, sensibility was in no way disturbed. The tube was im-
mediately reapplied, and a smart burning sensation was produced
which increased in severity for about three minutes; the
sensation then began to diminish and a numb feeling supervened.
On removing the glass, after fifteen minutes application, the
cuticle looks pale, and the ring of the tube is surrounded by aa
erethematous areola ; on pricking the spot with a needle, sen-
sation was quite absent until the point penetrated the cuticle,
when a slight amount of sensation became apparent ; no blood
followed for nearly half a minute : as the numbness passed away
burning and tingling returned, remaining super-sensitive for
some hours.
Experiment 2. — Chloroform Vapour. I applied the mouth
of a tube containing about 1 drachm of chloroform to my arm,
holding the lower part of the tube in my hand to induce
freer evaporation; in five minutes the skin became slightly
reddened, and I experienced a slight tingling sensation, which
merged into one of irritation, but never amounted to pain. On
removing the glass on the expiration of fifteen minutes, sensi-
bility was decidedly diminshed, though not abrogated ; it speedily
returned, no unpleasant effect remaining.
Case 1. — ^In a very distressing case of neuralgia of the
scalp that came under my notice, lint dipped in chloroform was
applied to the scalp, the whole carefully covered with oilsilk,
to hinder too rapid evaporation, this gave entire relief from
pain, which continued for some hours, allowing the patient to
33 6 Observations on a few Local AncestheHcs,
get some refreshing sleep. A slight amount of irritation of
the skin being the only inconvenience.
Case 2. — In a case of frontal neuralgia, the application of
the liquid chloroform gave complete relief in about t^n minutes;
but in this case, local irritation and diminished common sensi-
bility resulted. In the same case, on another occasion, the
vapour of chloroform removed the neuralgia in about fifteen
minutes, the common sensibility of the part was not at all
interfered with, nor were there any signs of local irritation.
Case 3. — I watched a case of carcinoma uteri for some
time, in which the vapour of chloroform was being used as a
local application, it being brought into contact with the os by
means of an elastic tube fastened at one end to a flask con-
taining fluid chloroform. It generally gave great relief from the
harrassing pain, but I found that its good effects could not be
always implicitly relied upon, and I have heard the same
remarked in other cases similarly treated, the pain being at one
time removed, in others, only slightly, or not at all relieved.
For this I know no explanation.
Experiment 3. — Chloroacetisation. During the early part of
last year, I noticed that a new mode of producing local anaes-
thesia, had been brought before the French Academy, by M.
Toumie, who calls the process " Chloroacetisation," and bases its
merits on the rapidity with which anaesthesia is produced, and
the slight inconvenience caused to the patient. I was much
interested in reading M. Toumi^'s communication, and deter-
mined to give it a fair trial. The process is as follows : — 1 3
of glacial acetic acid, and 45 m of chloroform are put into a
tube, and the mixture applied to the sound skin ; the part to
be acted upon being marked off" by a piece of diachylon plaster.
The mixture to be kept at the temperature of the hand. Under
these circumstances, M. Toumi^ says anaesthesia is to be looked
for in about flve minutes. I applied a mixture prepared as
above to the inside of my fore-arm. It immediately caused
a burning sensation, followed in about twenty seconds by most
Observations on a few Local AnofHheties. 887
acute smarting, increasing rapidly to the most excruciating
pain, and compelling me to remove the tube, and apply cold
water for relief; the cuticle was reddened and blistered, the
smarting continued severe afterwards, and the part looked as if
it had been severely stung by stinging nettles, indeed, the pain
was very similar to that produced by them. It would have
been quite impossible to have borne the application of this
mixture for five minutes, as M. Tourni^ desires.
Chloroform seems to assist the action of the acetic acid
severe enough in itself, by favouring its rapid absorption, and
we know that a solution of Belladonna in chloroform, acts
with tenfold greater rapidity than an ordinary one.
Experiment 4. — I next tried the effects of the vapour of the
acetized chloroform, the which was to produce redness, heat,
and tingling, in five minutes, which gradually increased up to
stinging, when I removed the glass. No anaesthesia was
induced in either of these cases.
Eocperiment 5. — Ice as a local anaesthetic.
This method of producing anaesthesia was introduced by Dr.
J. Amott, and is one of the most successful By making a
mixture of 2 parts of pounded ice and one of salt in a muslin
bag, and applying it to the skin, I have in fifteen minutes pro-
duced the most perfect local insensibility; the skin acquires a
parchmenty appearance, and becomes hard and homy.
Case 4. — I have seen this method applied in two instances
to cases of hernia, one of which occurred in an old woman,
and was of the femoral variety ; the intestine had been stran-
gulated in the same way upon a former occasion, and she was
operated upon while under the influence of Chloroform. The
patient, though she made a good recovery, suffered from that
time with almost continual headache. When I first saw the
case, the taxis had been employed for a considerable time with-
out any good result, so a bag of ice was placed over the
tumour, and kept there for five or six hours, hoping that re-
duction might thus be effected ; after this, the taxis wse «%^\sk
336 Observations an a fmv Local AncBsthdics.
tried without success ; a freezing mixture was then applied and
maintained for about an hour, and the operation for reduction
was proceeded with, the stricture was divided, the bowel re-
turned, and a suture introduced, without giving the patient any
pain ; she made a good recovery.
Case 5. — ^The other case was that of a man suffering from
an old inguinal hernia, which became strangulated, the tumour
was large ; the taxis was tried, and failed, both before and after
the application of ice ; ice and salt were maintained in contact
with the tumour for about an hour, and perfect anaesthesia
being produced, the case was operated upon, and the gut re-
turned ; no pain was experienced during the operation.
In this case the patient died three days afterwards, from
peritonitis, produced by the very severe strangulation of so
large a portion of gut and omentum.
Case 6. — A friend of mine had a large number of external
haemorrhoids removed, insensibility being produced by the use
of a freezing mixture ; he experienced no pain, and only a few
drops of blood were lost. I consider in cases requiring opera-
tion, that ice is, without doubt, the most valuable means for
inducing local anaesthesia, from its admitting of simple applica-
tion, and from the very small amount of haemorrhage that oc-
curs in all cases in which it is employed ; and I think that all
the following operations might be painlessly performed by this
method :
1. The removal of small superficial tumours, embracing
malignant, cystic, benignant, and other growths.
2. The operation for the reduction of paraphymosis.
3. The operation for onychia.
4. The opening of anthrax, and acute and chronic abcesses,
when superficial
5. The operations for the various kinds of hernia.
6. Excision of external piles.
Carbonic acid gas, when applied to the healthy akin, pro-
duces no effect beyond a slight sensation of warmth, but I
ObservatioTis on a few Local AncestJietics. 339
have seen very good results from its local application in cases
of cancer of various parts, especially after the destruction of the
cutaneous surface; when it, besides relieving the pain, neu-
tralizes the foefh(i odour, from which the patients suffer almost
as much as from the pain itself; and it is thus a great boon
to those about them.
In three cases of carcinovia nteri, and two of cancer of the
breast, I have seen it used, without in any case producing un-
pleasant results, or failing to give reliet
I would mention that it is better to use sulphuric acid in
the preparation of carbonic acid gas, for when the hydrochloric
is employed the gas requires to be washed before being brought
into contact with excoriated parts, being apt to contain hydro-
chloric acid in vapour, which may give rise to considerable irri-
tation and pain.
DISCUSSION.
Dr. Wyld thought that practitioners of Homoeopathy were
apt to neglect the use of local anaesthetics. He had repeatedly
met with cases of neuralgic pains, which had not yielded to
carefully chosen Homoeopathic remedies given internally, but
which had yielded at once, and permanently, to the application
of chloroform liniment. No doubt it would have been a greater
proof of skill to have cured such cases by cleverly selected
medicines. Still, our great object is to relieve pain, and cure
disease as quickly as is consistent with safety. To heal rapidly
external eruptions by external applications, is often dangerous ;
but the healing of neuralgic affections by externally applied
Anaesthetics, was always a safe process, and frequently a success-
ful one.
Mr. Cutmore said — Dr. Cronin's paper upon anaesthetics is a
very interesting one. As regards chloroform, it is a great boon
in the practice of midwifery, especially at the point where the
head is passing over the perinenum, and the anguish is greatest
also where there is much rigidity of those parts. But I think
that Homoeopathic remedies are not without their blessings in
this kind of cases. Gelseminum Semperviren is of that class,
and if given in drop doses of the 3rd dil. it acts as a power-
ful relaxor of all mascular fibre, and a calmer of the nervous
system, which, at those times is a great boon to such patients.
I have given it for some time, and it has never disappointed me.
22*
840 ObuTvationB on a few Local Afuesthitie$.
There is another medicine which I place great reliance upon,
that is GonlaEhyllum, and I think it equal to the former, hut its
action uponttie uterus is generally, where there is a want of
expulsive power, rather than rigidity of the os uteri.
Dr. Drury regretted that the author of this paper was not
present It was always desirable, that those who favoured the
Society with their opinions should have the opportunity of hear-
ing what was said, either in the way of censure or praise;
happily, on this occasion, there was no room to find fault, on the
contrary, the enquiries of the author showed a large amount of
careful, steady investigation, resulting in a very interesting
paper, and gave promise of more extended researches at a future
day. It appeared as one of the valuable practical results of
applying cold, with a view to produce local anaesthesia, that
haemorrhage was controlled by its use, the value of this, in
many operations was very great, facilitating the operation and
saving the patient's strength. Dr. Cronin had spoken of Car-
bonic acid gas as an agent that might be employed with
advantage. In its condensed form it was valueless, as it acted
as a powerful escharotic, but applied as a gas it was capable, at
times, of allaying pain ; it was, of course, in many cases inappli-
cable, but it had been used, and there was no reason why it
should not again be employed, if it could be made more manage-
able. Some gentlemen, it was said, objected to the use of
local anaesthetics ; unless there was a special reason in any
particular Jcase, it seemed to him, (Dr. Drury) that in many
cases their use was very desirabla If prompt and inmiediate
relief can be obtained by some local means, in no way affecting
or interfering with the action of our remedies, there could be no
valid reason for rejecting such aid. If a patient consulted a
medical man, with painful ulcer of the rectum, though such
might be cured by Homoeopathic doses, yet if a division of
the mucous membrane across the ulcer secures a safe and speedy
cure, why should it not be done ? Mr. Cutmore had spoken
highly in favour of Gelseminum in labour, the only experience
he (Dr. Drury) had of it in such cases, was in a case of Mr.
Cutmore's, where he had given it to prevent abortion, but where
the patient had aborted notwithstauding. Dr. Drury, should,
however, say that he saw her after a railway journey, which waa
not calculated to keep off the threatened mischie£
Dr. Eussell said he hoped Dr. Cronin would pursue the line
of investigation he had entered on. The subject was full of in-
terest; there could be no doubt, that if for the general narcotism
produced by Chloroform and similar agents, we could substitute
merely local insensibility, the gain would be material Dr.
Hope, professor of Chemistry, in Edinburgh, used to describe
Observations on afiw Local Anassthetm. 341
Nitrous-oxide as afifording an elegant debauch. The inhalation of
Chloroform might be said to be looked upon as innocent intoxi-
cation. Intoxication it undoubtedly was ; it has all the stages —
first excitement, next insensibility, and lastly maiatae, and fre-
quently nausea and vomiting. Chloroform entered the blood,
and was borne to the brain, on which organ it produced it? intoxi-
cal effects. And he (Dr. Eussell) had known instances of pa-
tients suffering from these effects for months. It was, therefore,
most desirable to substitute for such a general action a merely
topical one, if such an one subserved the purpose. The only
case in which he had ever employed a local anaesthetic was that
of an infant suffering from a large scroftdous abscess of the
neck. To this he applied a mixture of salt and snow in a silk
pocket handkerchief, and then made a free incision, and evacua-
ted about a tea-cupful of pus. It was amusing to observe the
infant laughing at the very moment the skin — ^which was in-
flamed and very sensitive — ^was being handled and cut. In all
similar cases, such, for example, as operating in paronychia, it
would be easy to employ a f^oiific mixture, and it would avoid
giving intense^suffering. The employment of this class of
remedies for minor operations has been ably advocated by Dr.
Amott and others ; but the subject took a wider range when we
attempted to apply the same principle to the treatment of those
spasmodic diseases which began in some irritation of a periphe-
ral nerve and excited general convulsions. This was the case
in some instances of epilepsy. If we could deaden the spot at
the extremity at which the morbid irritation originated, we
might sometimes prevent it travelling to the centre, and so cut
short an attack. It is not impossible that even hydrophobia
might be controlled by some action on the nerves of the throat.
In short, the command of the incito-motor nerves would be an
immense gain of therapeutic power in many convulsive diseases,
and by a diligent study of local anaesthesia, we may ultimately
attain it. He (Dr. Eussell) was glad to find the subject in the
hands of one of our members, and he hoped at some future
occasion Dr. Cronin would give us fuller details of the result
of his experiments.
Mr. Cameron remarked, that many years before chloroform
was heard of. Dr. Toogood Downing (who gained the Jacksonian
Prize for his Essay on Neuralgia) had invented an instrument
•which he named the " Aneuralgicon " by means of which he
was enabled to use anaesthetics of various kinds locally, and
with decided success in many cases. He employed chiefly
Belladonna^ Opium, Coniimi, Tobacco, Hyoscyamus, Hops, and
Lactaca A portion of one or more of these agents was placed
in -ft imall foinace, which fonned the body of the infttrum^\i\,v!EA:
342 OhservaHom on a few Local AruesOieties.
ignited. A stream of air from a pair of small bellows was then
ilirtHtoil upon it The fames escaped into a hollow cone of
lh»xiblo mi>tal, under which they were confined, and applied to
tlu» i>iirt affected. The pain was generally speedily relieved.
Tho almost unavoidable escape of these powerful fiimes> and ilieir
inlialatii»u by the patient or those around him formed a serious
objivtion, according to Mr. Cameron's experience, to the general
use of this otherwise very convenient little instrument. K this
drawback could bo overcome, this mode of employing local
auiiv^tlu'tios ought to become a valuable one, and seemed de-
siTving of more attention than it ever received from the pro-
fession.
%nmh 0f i)^t g0S|jital
LECTUltE III.— ON ASTHMA.
By Db. Eussell.
TiiK triuisition from epilepsy to asthma is natural if we adopt
a pathological arrangement, and even in the purely practical
aspect of the two maladies there are so many points of resem-
blance, that the study of the one makes the comprehension
of tlio other an easier task. True, the contrast beween epi-
leptic and asthmatic persons is very great. Among the former
the majority avo greatly l>elow par in mental power and activity,
while among the latter the reverse is the rule, and asthma has
boon described as jpar excellence the complaint of the intellectual
class. It may be, that the rounded shoulders and stooping
gait which indicated the man of literature — ^before literature
took to the rifle — was mistaken for the peculiar formation of
the chest which is so characteristic of the asthmatic, that the
accustomed eye can at once recognise the sufferer from this
complaint the moment he turns his back ; or it may be, that
the peculiar nervous constitution of the asthmatic is highly
favourable to the development of intellectual vigour. So far
Lecture hy Dr. Russell. 343
as my observations have gone, they quite agree with the popular
belief. The asthmatics I have known have been persons of
unusual mental activity and energy.
So much for the contrast between epilepsy and asthma. The
resemblance between these two diseases consists in their both
being affections of the nervous system, of a profound kind,
connected with its original formation, which gives to it a ten-
dency to be excited into a peculiar paroxysm giving rise to
certain sensations on the one hand, and on the other, to
violent spasms of certain muscles. In asthma as in epilepsy,
what may be called the head quarters of the disease are in the
upper part of the spinal chord ; about the origin of the pneu-
mogastric nerves, and thence it extends along the whole of
their ramification nerve, giving to all the parts supplied
by this great source of organic sensibilty a preternatural
sensitiveness and a tendency to spasm. The morbid centre
of epilepsy is probably close to that of asthma^ but the
nerves thence proceeding, by producing a spasm of the throat
instead of the lungs, give rise to the phenomena of strangula-
tion. So contiguous, however, are the sources of the two
morbid currents, that cases are on record of the usual epileptic
fit being supplanted by an attack of asthma. One striking
example of this transmutation is thus recorded by Dr. Salter.
" The case was that of a man of about fifty years of age,
subject to epilepsy. His fits had certain weU-known premo-
nitory symptoms, and occurred with tolerable regularity; I
think about once a fortnight. On one occasion his medical
attendant was sent for in haste, and found him suffering from
violent asthma ; the account given by his friends was, that at
the usual time at which he had expected the fit, he had ex-
perienced the accustomed premonitoiy symptoms, but instead
of their being followed, as usual, by the convulsions, this violent
dyspnoea had come on. Within a few hours the dyspnoea went
oflF, and left him as well as usual. At the expiration of the
accustomed interval after this attack, the ordinary premonitory
344 Lectur$ hy Dr. Russell.
symptoms and the usual epileptic fit occurred. On several
occasions (I do not know how many) this was repeated, the
epileptic seizure being, as it were, supplanted by the asthmatic."
[Salter on Asthma, p. 44.]
Let us take the analogy between epilepsy and asthma as
our chie, and see whither it leads.
To begin with ; what is revealed by the examination of the
bodies of those who have died either of the eflfects of these
diseases, or who, although dying of other maladies, have suffered
from either of them ? As a rule, in neither has there yet been
found any constant structural change which can be held as an
organic cause of the symptoms ; but in both there have been
occasionally such changes observed, and in both the morbid
alterations have been in the nervous system.
That structural change is rare, we state on the high autho-
rity of Laenec, who says : — " Even at the period at which we
live, when the eyes of medical men are particularly directed to
the minute investigation of the anatomical character of diseases,
I have met with many cases in which it was impossible, after
the most minute research, to find any organic leison whatever
to which the asthma could be attributed." So much for the
rule ; now for the exceptions. In a case of fatal dyspnoea, the
body of the patient who had thus died was carefully examined
by the accomplished anatomist Beclard, who foimd, as the only
possible explanation of death, a tumour on one of the phrenic
nerves. Parry narrates a case of dyspnoea occurring in fits of
aggravation, without any symptoms of local pulmonary disease,
and on dissection he found morbid alterations in the upper
cervical vertebrae, the result of syphilitic action upon the bones
of the neck. Lastly, Dr. Gardener relates a case characterized
during the life of the patient by paroxysms of dyspnoea, and
the post mortem examination disclosed, as the cause of the
asthmatic attacks from which he suffered, a neuromatous
tumour of the par vagum. [Ed. Med. Surg. Joum. 1850.]
Sir John Forbes makes upon this class of cases the following
Lecture h/ Dr. RusBtlk 346
practical observations : — " The influence of spinal irritation in
producing palpitation and other irregular action of the heart is
well known; and we apprehend, that many of the chronic
dyspnoeas and irregular asthmatic affections which we meet
with in persons who are deformed, arise as frequently from dis-
turbance of the spinal marrow, produced by the distortion, as
from disease of the lungs themselves." (Cyclopaedia of Med.
Asthma.)
In tracing the analogy and observing the contrast between
epilepsy and asthma, there is one point of diJBference which
arrests the attention. It is, that while epilepsy is often fatal,
asthma may be said never to be the immediate cause of death.
There are, indeed, one or two instances on record, which perhaps
ii^ay by some be considered as exceptions to this rule. Guersent
relates two cases of infants who died of an acute remittent
dyspnoea, with quick pulse, precordial anxiety, and dry cough,
and in whose bodies no organic lesion whatever could be found.
(Diet de Med. Prat., t. iii p. 126.)
Andral relates the following case : — " A baker of good con-
stitution, twenty years of age, who had lived in Paris for only
two months, and who had been affected for the last five or six
weeks with a slight diarrhoea, presented on the 10th of April
all the precursory symptoms of measles, — ^redness of the eyes»
coiyza, hoarseness, and cough. The same state on the three
following days. On the 14th, the eruption appeared; the
patient kept his bed. On the 15th, the entire body was
covered; entered La Charity on the evening of this day. The
eruption was then confluent, and quite characteristic; pulse
hard and frequent ; redness of tongue and lips ; violent cough ;
no other bad symptom. Towards the middle of the night the
patient felt some oppression ; this increased rapidly ; and on
the following morning, the 16 th, we found the patient in a
state of semi-asphyxia ; eyes full and prominent ; face purple ;
breathing short and very frequent, performed both by the ribs
and diaphragm ; cough almost constant, some . mucous €;^\\lW\
346 Lecture hy Dr. Russell.
the chest when percussed sounded well in every part; auscul-
tation caused some mucous rSle to be heard in different places.
Of the eruption there remained some pale spots just on the
point of disappearing. The pulse preserved its frequency and
hardness, and the tongue its redness. This group of symptoms
seemed to indicate the existence of a pneumonia ; however,
the pathognomonic signs of this disease were completely
wanting. Could a simple bronchitis by its extreme acuteness
or sudden exasperation, give rise to so intense a dyspnoea ?
Could this inflammation in combination with that of the
primss viae explain the very severe state into which the
patient had so suddenly fallen ? Be this as it may, the indi-
cations to be fulfilled were no longer doubtful The internal
inflammation must be diminished, and that of the skin recalled.''
Andral attempted to effect this after his method, and the result
was, that under intense suffocation the patient died on the 20th.
The post-mortem examination revealed no morbid change of the
parenchyma of the lungs, only intense redness, and some
croupy exudation of the lining membrane of the bronchial
tubes. Andral, while on the whole inclining to consider the
case as one of fatal bronchitis, seems somewhat staggered as to
its pathology, for he observes : " Those who admit the existence
of nervous dyspnoea and essential asthmas, might cite this case
in support of their opinion ; they would say that they had often
seen the bronchial mucous membrane as intensely inflamed
without any perceptible dyspnoea resulting fix)m it ; from this
they would conclude that in the present case, the dyspnoea
was an essential disease, independent of the inflammation of
the bronchi" I have quoted this case in full because of its
pathological interest, both as raising the question as to whether
this baker died of nervous dyspnoea, and also as a proof of the
intimate relation between cutaneous and some pulmonary
affections.
As the cases referred to and the one quoted are almost the
ojAy ones recorded of presumed death by asthma, we may as-
Lecture ly Dr. Russell. 847
some that in tlfls Instance the exceptions prove the rule, and
that asthma is never fatal Why not ? If asthma be what it
is generally represented as being, a spasm of the muscular
structure which surrounds the extreme ramifications of the
bronchial tubes just as they loose themselves in the air cells,
— ^if this be the true pathology of asthma, then the conse-
quences would manifestly be, that the lung cells would be
deprived of the supply of air requisite to the maintenance of
life, and we should have the symptoms of death by strangu-
lation. For where is the difference to the individual, whether
he be choked by a ligature round his windpipe— or what is the
same thing, by spasmodic closure of the glottis, so that no air
is permitted to enter the tubes and be conveyed along them
through their subdivisions to the lungs, or whether the air so
entering be arrested at the extremities of these tubes, and the
craving of the parched air cells be left unsatisfied ? In the
former case the patient is suffocated by a wholesale process, and
in the latter, he is suffocated in detail ; but in both cases he is
equally suffocated, if by suffocation we understand depriving
the lungs of the supply of air necessary for life. And what do
we mean by suffocation ? We mean that the blood passes
through the lungs without being . there renovated as it should
be, — ^r^enerated, we might even say, — and that instead of living
arterial blood, dead venous blood is poured into the left auricle,
thence into the left ventricle, which in its turn discharges it
upon the brain, and produces there the effects which Sir A.
Cooper describes as having been exhibited by the rabbits, whose
carotid and cervical arteries he had tied, viz., coma, convul-
sions, and all the after phenomena of epilepsy. But in asthma
we have as nearly as possible the converse of all this. So far
fix>m there being coma or unconsciousness, there is quickened
perception; instead of convulsions, we have absolute stillness
of every limb and muscle, with one grand exception, the
mnades of respiration. All these, and none else, are in a
'Siite of violently exalted action. So that we may, without aja.^
348 Leettt/re hy Dr. Russdl.
conceit of language, call asthma epilepsy of the tespixatory
apparatus.
The respiratory apparatus consists of a certain arrangement
of muscles and of nerves, by which the chest is expanded and
the lungs inflated. Clearly to understand the phenomena of
asthma, we must fully comprehend these two sets of apparatus.
The muscles of the trunk which are brought in aid of the
common respiratory muscles are thus described by Sir C. Bell : —
*' If we look upon the frame of the body for the purpose of
determining what are the muscles best calculated to assist in
the motions of the chest when there is an increased or excited
action, we shall have little difficulty in distinguishing them;
and we shall have as little hesitation in assigning a use to the
nerves which supply those muscles exclusively. These muscles,
in effect we see powerfully influenced by deep inspiration, how-
ever excited. They are the mastoid muscle, the trapezius, the
serratus magnus, and the diaphragm. They operate in a circle,
and all would be useless in the act of respiration were one to be
wanting. The servatus magnus expands the ribs ; but this it does
only when the scapula, to which it is attached, is fixed ; and unless
the scapula be fixed, this muscle has no operation in breathing.
The trapezius fixes the scapula by drawing it backwards and
upwards. These two muscles must always correspond in action
in order to expand the chest. Now let us see how the tra-
pezius influences the operation of the stemo-cleido-mastoideus.
The mastoid muscle elevates the sternum ; but only when the
head is fixed, which is done by the action of the trapezius on
the back of the head and neck. To this train of coimections
we may join the diaphragm itself, since, without the action of
the serratus, the margins of the thorax would sink in by the
action of the diaphragm, and the force of that muscle would be
consequently lost."
This description by the masterly pen of Sir C. Bell, exhibits
at once the peculiar form of the upper part of the back, and
habitual attitude of the asthmatic His shoulder-bladei haT«
Lecture hy Dr, Russell, 349
been so often raised and fixed, to give purchase to his serrati
muscles, that his shoulders have become permanently round
So much for the external muscles of respiration. Let us
now glance at the sketch by the same hand of the nerves
devoted to associate these muscles in combined action. *' The
nerves on which the associated actions of voluntary BJid excited
respiration depend, arise very nearly together. Their origins
are not in a bimdle or fasciculus, but in a line or series, and
form a distinct column of the spinal marrow. Behind the
corpus olivare there is a portion of the medulla which belongs
neither to the motor nor to the sensitive tracts, and which on
dissection wiU be found to have more direct connection with
the corpus restiforme. This fasciculus, or virga, may be traced
down the spinal marrow between the sulci, which gives rise to
the anterior and posterior roots of the spinal nerves."
" From this tract of the medullary matter on the side of the
medulla oblongata arise in succession from above downwards,
the portio dura of the seventh nerve, the glosso-pharangeus ; the
nerve of the par vagum, the nervus ad par vagum accessorius,
and, as I imagine, the phrenic and external respiratory nerves."
Thus the principal seat of the power which controls respira-
tion is within a very narrow compass. Now as epilepsy is
held by Schroder van der Koch to arise from a morbid con-
dition of a small portion of the medulla oblongata, so pro-
bably does asthma, or at least the disposition to asthma, de-
pend upon a chronic-inflammation (shaU we say?) of a
contiguous part of this vital structure ; and as the only con-
ceivable means of a radical cure of epilepsy, is by remedies
which act upon the origin of the disease, so I believe that we
shall find that to cure asthma we must look not so much at
the outward manifestation of the malady, as at its inward
source. Suppose we are right in this interpretation of the
pathology of asthma, and that the disease depends upon a
morbid condition of what for want of a better name, we may
denominate, after Bell, the respiratory tract ; what should we
3 50 Lecture hy Dr, Russell
expect to result from such a condition of the origin of the
nerves? Let us see what takes place in epilepsy. Here
we have, in consequence of a similar state of the roots of the
nerves of common sensation and motion, the following pheno-
mena.
Ist. A peculiar morbid sensation — a modification of the
ordinary sense of feeling, known by the term, av/ra epilqptica-
2nd. After this peculiar sensation has been borne inward to
the centre, we have by the law of reflex action, certain twitches
in the muscles of the face and eye, because the roots of the
nerves which supply these muscles, have been excited by the
in-borne impulse known as a sensation.
What have we in asthma ?
Suppose the nervtcs vagtcs to be morbid at its root, what
should we expect to be the phenomena ? Why, that as one of
its offices is to endow the lungs, not with common sensibility,
but with the peculiar sensibility which enables them to per-
ceive the presence of unoxynated blood, and to transmit an
order, so to speak, for a fresh supply of air, that they may be
permeated by the vital fluid ; so, when there is a morbid con-
dition of the pulmonary branch of this nerve, there is, as a
necessary consequence, a preternatural sensitiveness to the
natural stimulus, and hence there is a cruel craving for fresh
air, giving rise to a sense of suffocation." This sense of
suffocation, when it arrives at the centre of consciousness and
the origin of motion, immediately calls into the greatest ac-
tivity the whole muscular apparatus at its disposal, to relieve
the anguish produced by this intolerable sensation — ^this true
mimic death — long drawn out — which the asthmatic endures ;
a sense of suffocation — but not suffocation — ^is the essence of
asthma, for there is no lack of air in the lungs. Instead of
there being too little air in them, they are distended almost to
bursting; but the air does not satisfy the craving. The
patient sits with his mouth open, gasping like a fish out of
water. From the mouth and nostrils to the innermost cells of
Lecture by Dr. Rvssell. 351
the lungs, there Is no Impediment to the entrance of the vital
breath ; but it does, so far as his sensatisns go, no good. How
does this affect the circulation ? The over-distended air-cells
do not permit a free entrance of blood through their capillary
vessels: the consequence is, that along with an inordinate
appetite for, not air, but vivication of the blood — this being
what we mean when we speak of want of breath — ^there is a
deficiency in the process by which the venous blood is reno-
vated. Too small a quantity passes through ; what does pass
however, undergoes the necessary changes ; it reaches the left
auricle in a sparing stream, but what gets there is arterial
living blood, not dead venous blood. This limited supply of
stimulating blood, excites the heart, which propels it rapidly
but feebly through the system at large, and up to the brain.
The pulse is rapid and small in consequence ; the skin shrivelled
and cold ; the brain clear— often wonderfcdly cleai' — ^but not
fit for any effort
If the air instead of entering, as I believe it does, the
tissue of the lungs, were shut off, as our authorities tell us it
is, what would be the condition of the blood ? Why, manifestly
it would be yenous, and we should have venous blood entering
the left side of the heart, and thence transmitted through the
brain. Now if for hours this was to go on, how is it possible
that the person could avoid manifesting the unequivocal sjnoap-
toms of venous congestion of the brain ? We know what these
are, — ^we know exactly how long it takes to induce coma and
convulsions, and yet there is no instance on record of either
coma or convulsions being induced by attacks of asthma, even
although of the severest and most enduring kind.
Among the arguments usually advanced in support of what
I look upon as the erroneous though prevailing doctrine of
asthma being a spasm of the entrance of the air-cells, one
much dwelt on is the instant relief which is given by what
are considered sedatives. I believe there is here a double
fidlacy; first, that what is relieved is not a preventing spaam.^
352 Lecture by Dr. Russell,
but an uneasy sensation — anxiety — and that the so-called
sedatives relieve this either in virtue of their specific action on
the nerves, by curing the morbid condition of which this is a
symptom, — as happens when Ipecacuhana and Lobelia do it, or,
when Chloroform and Opium are the means successfully em-
ployed, it is in virtue of their primary or stimulating, and not
their sedative action, that they effect the change. Nothing
exemplifies this better than the relief given by burning nitre-
paper, one of the palliatives most frequently efficacious. So
far from the fumes of the nitric-oxide, which is liberated by
the combustion of the nitre being of a sedative or soothing
nature, they are intensely irritating to the air passages, so that
a person who has riot asthma, if he attempt to breathe this
vapour, is certain to be attacked with a sense of suffocation and
a fit of coughing.
While we regard the essence of asthma to be an exaltation
of the peculiar or specific sensibility of the pulmonary branch
of the par vagum, from some morbid condition of that portion
of the spinal chord whence this nerve springs, as well as a
morbid state of the other nerves of inspiration depending upon
something vicious at their roots, so that they convey an un-
natural stimulus to the muscles they supply, which induces
them to take on a spasmodic action — just as those of the
limbs do in epilepsy, we must at the same time remember
that the functions of the nervus vagus is very complex, and that
it is not merely a nerve endowing the lungs with their peculiar
sensitiveness to the presence of venous blood in their capillaries ;
but also the source of nervous influence to 
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